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Comparison of the Outcomes according to the Injury Type of the Short Radiolunate Ligament in Fracture-Dislocation of the Radiocarpal Joint (요수근 관절의 골절-탈구에서 단요월상인대의 손상 형태에 따른 치료 결과의 비교)

  • Heo, Youn Moo;Kim, Tae Gyun;Song, Jae Hwang;Jang, Min Gu;Lee, Seok Won
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.51-60
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    • 2021
  • Purpose: Radiocarpal dislocation (RCD), which is caused by high-energy trauma, often involves radial styloid fractures and short radiolunate ligament (SRLL) injuries. Although SRLL injuries may occur as a simple rupture at the attachment site of radius, it may occur with a relatively large avulsed-fragment in the volar rim of the lunate facet of the radius. This study aimed to differentiate the injury type of SRLL and assess the differences in the treatment results depending on the treatment methods that have been applied in RCD with radial styloid fractures. Materials and Methods: Eighteen patients managed surgically with RCD were enrolled in this study. The patients were classified as Group 1 and Group 2 by using the Dumontier method. In this study, Group 2 was subdivided into 2A (purely ligamentous or small avulsion fracture of the volar rim of lunate facet) and 2B (large avulsed-fragment enough to internal fixation) according to the injury type of SRLL. Groups 2A and 2B were treated with direct repair and screw fixation, respectively. Pain, range of motion of the wrist joint, grip strength, and complications on final radiographs were examined. The outcomes were evaluated using patient-rated wrist evaluation (PRWE), and modified Mayo wrist score (MMWS). Results: All patients were Group 2 (six and twelve patients in 2A and 2B, respectively). The mean flexion to extension arch recovered 79%,and the mean grip strength was 72.9% of the uninjured side. Group 2A showed better recovery in extension, flexion and pronation than Group 2B, but there was no difference in radial deviation, ulnar deviation, supination, grip strength and pain. No differences in the PRWE and MMWS were observed between two groups. Complications included traumatic arthritis in seven patients and residual instability in five patients. Conclusion: When the SRLL was injured, the involvement of a large avulsion fracture on the anterior plane of the radiolunate did not affect the test results. On the other hand, it should be observed cautiously because avulsion fractures tend to disturb the joint's reduction through rotation or displacement. In addition, anatomical reduction and sturdy internal fixation are important for restoring the function of the SRLL.

A comparative study on head posture and craniofacial morphology between koreans and scandinavian caucasians (한국인과 스칸디나비아계 백인의 두부자세와 두개안면구조의 형태에 관한 비교연구)

  • Oh, Yong-Duck;Yoon, Young-Jooh;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.29 no.6 s.77
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    • pp.707-720
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    • 1999
  • The purpose of this study was to evaluate racial differences In head posture and the influence of head posture to the craniofacial morphology. The sample group of this study was made up of 51 Korean males and 120 Scandinavian Caucasian males. From the comparison of the cranio-cervical angle and the variables of craniofacial morphology between them, the following results were obtained. 1. The cranio-cervical angle (NSL/OPT) was on average 9.28 degrees larger In Koreans. 2. The length of the anterior cranial base (N-S) was on average 4.66mm shorter in Koreans. 3. The length of the maxillary base (sp-pm and ss-pm) were on average 2.75mm and 4.65mm shorter in Koreans respectively, the anterior maxillary height (n-sp) was on average 2.60mm longer, the posterior dimension (s-pm) was found to be 2.06mm longer in Koreans, and the maxillary inclination (NSL/NL) was identical in both samples. 4. The mandibular body length (pg-tgo) and ramus height (ar-tgo) were identical in the two groups, but the genial angle (ML/RL) was 3.22 degrees smaller and the mandibular plane inclination (NSL/ML) was 2.44 degrees larger in Koreans 5. The maxillary prognathism (s-n-sp and s-n-ss) and the mandibular prognathism (s-n-sm) were identical in both samples. 6. The sagittal jaw relationship (ss-n-pg) was 1.44 degrees larger in the Korean sample, but the vortical jaw relationship (NL/ML) was not significantly different. 7. The anterior facial height (n-gn) was 5.57mm longer in the Korean sample. 8. The mandibular alveolar prognathism (CL/ML) was 5.71 degrees greater and the interincisal angle (ILs/ILi) was 3.08 degrees more acute in Koreans. Taken together these results, craniofacial morphology can be influenced by the head posture defined by cranio-cervical angulation.

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A New Approach with Combined Stereotactic Trans-multiarc Beams for Radiosurgery Based on the Linear Accelerator : Photon Knife (입체적횡다증회전조사를 병합한 방사선수술의 새로운 접근 : 포톤나이프)

  • Choi, Tae-Jin;Kim, Jin-Hee;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • v.14 no.2
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    • pp.149-158
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    • 1996
  • Purpose : To get an accute steepness of dose gradients at outside the target volume in intracranial lesion and a less limitation of beam selection avoiding the high dose at normal brain tissue, this Photon Knife Radiosurgery System was developed in order to provide the three-dimensional dose distribution through the reconstruction of CT scan and the combined stereotactic trans-multiarc beam mode based on linear accelerator photon beam. Materials and methods : This stereotactic radiosurgery, Photon Knife based on linear accelerator photon beam was provided the non-coplanar multiarc and trans-multiarc irradiations. The stereotactic trans-multiarc beam mode can be obtained from the patient position in decubitus. This study has provided the 3-dimensional isodose curve and anatomical structures with the surface rendering technique. The dose distribution from the combined two trans-multiarcs (2M 2TM) was compared to that of four non-coplanar multiarcs (4M) with same collimator size of 25 mm in a diameter and total gantry movements. Results : In this study, it shows that the dose distributions of stereotactic beam mode are significantly depended on the selected couch and gantry angle in same collimator size. Practical dose distribution of combined stereotactic trans-multiarc beam has shown a more small rim thickness than that of the non-coplanar multiarc beam mode in axial, sagittal and coronal plane in our study. 3-Dimensional dose line displayed with surface rendering of irregular target shape is helpful to determine the target dose and to predict the prognosis in follow-up radiosurgery. Conclusions : 3-Dimensional dose line displayed with surface rendering of irregular target shape is essential in stereotactic radiosurgery. This combined stereotactic trans-multiarc beam has shown a less limitation of the selection couch and gantry beam angles for the target surrounding critical organs. It has shown that the dose distribution of combined trans-multiarc beam greatly depended on the couch and gantry angles. In our experiments, the absorbed dose has been decreased to $27%$ / mm in maximum at the interval of $50\%$ to $80\%$ of isodose line.

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Palaeomagnetism of the Okchon Belt, Korea : Anisotropy of Magnetic Susceptibility (AMS) and Deformation of the Hwanggangri Formation in Chumgju-Suanbo Area (옥천대에 대한 고자기 연구:충주-수안보 일원 황강리층의 변형과 대자율 비등방성(AMS))

  • Son, Moon;Kim, In-Soo;Kang, Hee-Cheol
    • Economic and Environmental Geology
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    • v.34 no.1
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    • pp.133-146
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    • 2001
  • We report the results of structural field observation and measurement of anisotropy of magnetic susceptibility (AMS) of the diamictitic Hwanggangri Formation distributed in Chungju-Suanbo area of the Okchon Belt, Korea. The outcrops of the Hwanggangri Formation show two types of cleavage in general: slaty cleavage (SI) and crenulation cleavage (5z). 5] cleavage is, however, well observable only in the notheastem (NE) part of study area, while overwhelmed by 52 cleavage in the southwestern (5W) part, indicating stronger later deformation in 5W part of the study area. This partitioning of the study area is corroborated by both IRM and AMS parameters: NE part of the study area is characterized by higher IRM intensity, higher bulk magnetic susceptibility, higher AM5 degree, and by oblate shape of magnetic susceptibility ellipsoid. Their values become drastically lowered toward southwest, and reach to a stable minimum in the whole 5W part of the study area. In addition, degree of both metamorphism and deformation tends to increase gradually from northeast toward southwest and also from northwest toward southeast in the study area. Based on the distribution pattern of the principal axes ( $k_1, k_2, k_3$ axes) of magnetic anisotropy ellipsoids revealed in the NE part of the study area, three episodes of deformation ( $D_1, D_2, D_3$ ) are recognized: D_1$ deformation produced $S_2$ cleavage with NE-5W trend, which is caused by a strong NW-SE tlattening of a coaxial pure shear. $D_2$ deformation produced 5z cleavage characterized by a non-coaxial deformation. It was caused by a ductile or semi-ductile thrusting toward NW and concurrent sinistral shearing along $S_2$ cleavage plane. Lastly, $D_3$ deformation produced tlexural folding of all previous structures with a nearly horizontal NE fold axis. Distribution pattern of the principal axes of magnetic anisotropy ellipsoid from the SW part of the study area, on the other hand, does not show any coherency among sites or samples. We interpret that this dispersed pattern of $k_1, k_2, k_3$ axes together with lower anisotropy strength indicates that magnetic fabrics in the SW part have been disturbed either by a superposition of strong deformation/metamorphism or by a kind of reciprocal strain due to an overlapping of $D_1$ and $D_2$ or by both processes.

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Analysis of Tidal Deflection and Ice Properties of Ross Ice Shelf, Antarctica, by using DDInSAR Imagery (DDInSAR 영상을 이용한 남극 로스 빙붕의 조위변형과 물성 분석)

  • Han, Soojeong;Han, Hyangsun;Lee, Hoonyol
    • Korean Journal of Remote Sensing
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    • v.35 no.6_1
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    • pp.933-944
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    • 2019
  • This study analyzes the tide deformation of land boundary regions on the east (Region A) and west (Region B) sides of the Ross Ice Shelf in Antarctica using Double-Differential Interferometric Synthetic Aperture Radar (DDInSAR). A total of seven Sentinel-1A SAR images acquired in 2015-2016 were used to estimate the accuracy of tide prediction model and Young's modulus of ice shelf. First, we compared the Ross Sea Height-based Tidal Inverse (Ross_Inv) model, which is a representative tide prediction model for the Antarctic Ross Sea, with the tide deformation of the ice shelf extracted from the DDInSAR image. The accuracy was analyzed as 3.86 cm in the east region of Ross Ice Shelf and it was confirmed that the inverse barometric pressure effect must be corrected in the tide model. However, in the east, it is confirmed that the tide model may be inaccurate because a large error occurs even after correction of the atmospheric effect. In addition, the Young's modulus of the ice was calculated on the basis of the one-dimensional elastic beam model showing the correlation between the width of the hinge zone where the tide strain occurs and the ice thickness. For this purpose, the grounding line is defined as the line where the displacement caused by the tide appears in the DDInSAR image, and the hinge line is defined as the line to have the local maximum/minimum deformation, and the hinge zone as the area between the two lines. According to the one-dimensional elastic beam model assuming a semi-infinite plane, the width of the hinge region is directly proportional to the 0.75 power of the ice thickness. The width of the hinge zone was measured in the area where the ground line and the hinge line were close to the straight line shown in DDInSAR. The linear regression analysis with the 0.75 power of BEDMAP2 ice thickness estimated the Young's modulus of 1.77±0.73 GPa in the east and west of the Ross Ice Shelf. In this way, more accurate Young's modulus can be estimated by accumulating Sentinel-1 images in the future.

Comparison between Propofol/Remifentanil and Ketamine/Remifentanil for TIVA in Beagle Dogs (비글견에서 Propofol/Remifentanil과 Ketamine/Remifentanil을 사용한 완전 정맥 내 마취법의 비교)

  • Choi, Woo-Shik;Jang, Hwan-Soo;Park, Jai-Soon;Yun, Sung-Ho;Kwon, Young-Sam;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.28 no.5
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    • pp.479-485
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    • 2011
  • The cardiopulmonary responses during total intravenous anesthesia (TIVA) between remifentanil/propofol infusion and remifentanil/ketamine infusion in dogs were compared. Fourteen healthy adult beagle dogs were premedicated with acepromazine (0.1 mg/kg, SC) and medetomidine (20 ${\mu}g$/kg, IV), and anesthetized for 3 hr with remifentanil (0.5 ${\mu}g$/kg/min)/propofol (loading dose: 1 mg/kg, CRI: 0.3 mg/kg/min) CRI (group 'P') or remifentanil/ ketamine (loading dose : 5 mg/kg, CRI: 0.1 mg/kg/min) CRI (group 'K'), respectively. Hemodynamics, blood gas analysis and behavioral changes during recovery were measured. The level of anesthesia was determined by toe-web clamping test. The level of surgical anesthesia was maintained throughout the experiment in both groups. Systolic arterial pressure, mean arterial pressure, $PaO_2$ and $SpO_2$ in group 'K' were significantly higher than in group 'P', and were maintained near the normal ranges. In addition, $PaO_2$ in group 'K' was significantly lower than in group 'P'. However, diastolic arterial pressure, heart rate and respiratory rate were not significantly differed. Mean extubation time from the end of infusion was significantly reduced in group 'K', but mean sitting time was significantly reduced in group 'P'. Mean head-up time and mean walking time were not significantly differed. In group 'K', brief muscle rigidity, head waving and licking during recovery were observed. In conclusion, infusion rate of ketamine (0.1 mg/ kg/min) with remifentanil (0.5 ${\mu}g$/kg/min) is an appropriate for obtaining the surgical plane of anesthesia. These results showed that group 'K' had better cardiopulmonary function than group 'P'. That is, remifentanil/ketamine CRI is better TIVA protocol than remifentanil/propofol CRI for 3 hr surgery.

Comparision of Trans-Tibial and Anteromedial Portal Approach in Femoral Tunneling of Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술의 대퇴골 터널 굴착시 경경골 접근법과 전내측통로 접근법의 비교)

  • Sohn, Sung-Keun;Chang, Yun-Suk;Chung, ll-Kwon;Kim, Kyung-Taek
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.75-81
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    • 2004
  • Purpose: Recent development and advances in arthroscopic surgical techniques for Anterior Cruciate Ligament(ACL) reconstruction have led to the ideal location for the etric point from 10 o'clock (in right knee) and 13:30 (in left knee) to 10:30 (in right knee) and 14 o'clock (in left knee) in the frontal plane. This study was performed to compare operative methods and the radiologic results of femoral tunnels made through the tibial tunnel(trans-tibial approach) and the anteromedial portal. Material and Methods: From January 2003 to May 2004, one-hundred reconstructions of anterior cruciate ligament were performed. Group I (femoral tunnel through tibial tunnel) was composed of 50 cases and group ll (femoral tunnel through anteromedial portal) was consisted of 50 cases. The study was performed to compare the radiographic results of femoral tunnels made through the tibial tunnel and the anteromedial portal and operative methods. Results: In operative methods at Group II, femoral tunnel was made more easily at isometric point than Group I, a good visual field was achived because 100$^{\circ}$ flxion of knee, they can be reduced risk of posterior cortical breakage and tunnel-graft mismatching and decreased divergence of femoral interference screw in radiology (P<0.05). The angle between femoral tunnel and longitudinal axis of ACL wae increased at Group ll. Conclusion: Aanteromedial portal technique was more useful in ACL reconstruction for femoral tunnel toward 10 o'clock to10:30(in right) or 1:30 to 2 o'clock(in left).

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A Case Study on the Development of Real-Time Interactive Class Data among Non-face-to-Face Remote Class Types (비대면 원격수업 형태 중 실시간 쌍방향 수업 자료 개발 사례 연구: 고등학교 기하 과목 공간도형 단원의 평면의 결정 요건을 중심으로)

  • Lee, Dong Gun;Ahn, Sang Jin
    • Communications of Mathematical Education
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    • v.35 no.2
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    • pp.173-191
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    • 2021
  • This study noted that a survey of teachers in a leading study conducted in Korea during the Pandemics period pointed out that the "real-time interactive" classes account for a significantly small portion of the remote class format. Contentually, the study reported cases of developing and applying "real-time interactive" class materials based on "planar decision requirements" of high school mathematics subject geometry. The teacher who participated in the development was a math teacher who worked at a Seoul-based high school with 28 years of high school teaching experience, and a teacher who was in charge of geometry in the math department in 2020. The development teacher decided to develop real-time interactive classes. In particular, the materials were developed by organizing the class guidance plan in four stages: 'Meeting and Class Guidance', 'Giving motivation', 'Suggesting tasks', 'Individual Investigative Activities and Teacher Feedback' and 'Reflection and Evaluation' which were selected through the process of selecting the class contents and selecting online class tools. At this time, the development teacher produced and presented about five minutes of video material using the videooscribe, a whiteboard animation program. And in case of task number 8, it consisted of recording the students' free thoughts after class, which served as a role of assessment by students themselves and providing feedback to their teachers. This study is a case study that introduces a series of courses in which field teachers develop class materials, and in addition to presenting class materials that can be applied directly to classes, is a result of a study that focuses on the role of presenting samples for future class data development. The materials developed were verified as class materials based on the opinions of the students who participated in the class and the results of the evaluation commissioned by the three math teachers.

The Evaluation of the Difference of the SUV Caused by DFOV Change in PET/CT (PET/CT 검사에서 확대된 표시시야가 표준섭취계수에 미치는 영향 평가)

  • Kwak, In-Suk;Lee, Hyuk;Choi, Sung-Wook;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.13-20
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    • 2011
  • Purpose: The limited FOV(Field of View) of CT (Computed Tomography) can cause truncation artifact at external DFOV (Display Field of View) in PET/CT image. In our study, we measured the difference of SUV and compared the influence affecting to the image reconstructed with the extended DFOV. Materials and Methods: NEMA 1994 PET Phantom was filled with $^{18}F$(FDG) of 5.3 kBq/mL and placed at the center of FOV. Phantom images were acquired through emission scan. Shift the phantom's location to the external edge of DFOV and images were acquired with same method. All of acquired data through each experiment were reconstructed with same method, DFOV was applied 50 cm and 70 cm respectively. Then ROI was set up on the emission image, performed the comparative analysis SUV. In the clinical test, patient group shown truncation artifact was selected. ROI was set up at the liver of patient's image and performed the comparative analysis SUV according to the change of DFOV. Results: The pixel size was increase from 3.91 mm to 5.47 mm according to the DFOV increment in the centered location phantom study. When extended DFOV was applied, $_{max}SUV$ of ROI was decreased from 1.49 to 1.35. In case of shifted the center of phantom location study, $_{max}SUV$ was decreased from 1.30 to 1.20. The $_{max}SUV$ was 1.51 at the truncated region in the extended DFOV. The difference of the $_{max}SUV$ was 25.9% higher at the outside of the truncated region than inside. When the extended DFOV was applied, $_{max}SUV$ was decreased from 3.38 to 3.13. Conclusion: When the extended DFOV was applied, $_{max}SUV$ decreasing phenomenon can cause pixel to pixel noise by increasing of pixel size. In this reason, $_{max}SUV$ was underestimated. Therefore, We should consider the underestimation of quantitative result in the whole image plane in case of patient study applied extended DFOV protocol. Consequently, the result of the quantitative analysis may show more higher than inside at the truncated region.

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Scapular Free Flap (유리 견갑 피판 이식술)

  • Chung, Duke-Whan;Han, Chung-Soo;Yim, Chang-Moo
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.24-34
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    • 1996
  • There are many kinds of free flaps for management of extensive soft tissue defect of extremities in orthopaedic field. Free vascularized scapular flap is one of the most useful and relatively easy to application. This flap has been utilize clinically from early eighties by many microsurgical pioneers. Authors performed 102 cases of this flap from 1984 to 1995. We have to consider about the surgical anatomy of the flap, technique of the donor harvesting procedures, vascular varieties and anatomical abnormalities and success rate and the weak points of the procedure. This flap nourished by cutaneous branches from circumflex scapular vessels emerges from the lateral aspect of the subscapular artery 2.5-5cm from its lateral origin passing through the triangular space(bounded by subscapularis, teres minor, teres major, long head of triceps). The terminal cutaneous branch runs posteriorly around the lateral border of the scapular and divided into two major branches, those transeverse horizontally and obliquely to the fascial plane of overlying skin of the scapular body. We can utilize these arteries for scapular and parascapular flap. The vascular pedicle ranged from 5 to 10 cm long depends on the dissection, usually two venae comitantes accompanied circumflex scapular artery and its major branches. The diameter of the circumflex scapular artery is more than 1mm in adult, rare vascular variation. Surgical techniques : The scapular flap can be dissected conveniently with prone or lateral decubitus position, prone position is more easier in my experience. There are two kinds of surgical approaches, most of the surgeon prefer elevation of the flap from its outer border towards its base which known easier and quicker, but I prefer elevation of the flap from its outer border because of the lowering the possibilities of damage to vasculature in the flap itself which runs just underneath the subcutaneous tissue of the flap and provide more quicker elevation of the flap with blunt finger dissection after secure pedicle dissection and confirmed the course from the base of the pedicle. There are minimal donor site morbidity with direct skin closure if the flap size is not so larger than 10cm width. This flap has versatility in the design of the flap shape and size, if we need more longer and larger one, we can use parascapular flap or both. Even more, the flap can be used with latissimus dorsi musculocutaneous flap and serratus anterior flap which have common vascular pedicle from subscapular artery, some instance can combined with osteocutaneous flap if we include the lateral border of the scapular bone or parts of the ribs with serratus anterior. The most important shortcoming of the scapular free flap is non sensating, there are no reasonable sensory nerves to the flap to anastomose with recipient site nerve. Results : Among our 102 cases, overall success rate was 89%, most of the causes of the failure was recipient site vascular problems such as damaged recipient arterial conditions, and there were two cases of vascular anomalies in our series. Patients ages from 3 years old to 62 years old. Six cases of combined flap with latissimus dorsi, 4 cases of osteocutaneous flap for bone reconstruction, 62 parascapular flap was performed - we prefer parascapular flap to scapular. Statistical analysis of the size of the flap has less meaningful because of the flap has great versatility in size. In the length of the pedicle depends on the recipient site condition, we can adjust the pedicle length. The longest vascular pedicle was 14 cm in length from the axillary artery to the enter point cutaneous tissue. In conclusion, scapular free flap is one of the most useful modalities to manage the large intractable soft tissue defect. It has almost constant vascular pedicle with rare anatomical variation, easy to dissect great versatility in size and shape, low donor morbidity, thin and hairless skin.

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