• Title/Summary/Keyword: Prosthetic Leg

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Leg Amputation due to Buerger's Disease: Management with Combined Korean Medicine

  • Won, Eun Sol;Lee, Hyun;Ryu, Hwa Yeon;Ku, Yong Ho;Jung, Ga Hyeon;Park, Chae Hyun;Kang, Jae Hui
    • Journal of Acupuncture Research
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    • v.38 no.4
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    • pp.325-330
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    • 2021
  • In this Case Report, a patient with Buerger's disease who had a leg amputation below his lower right knee and a vascular bypass of right leg, developed a wound caused by his prosthetic leg and subjective discomfort. The patient received skin flap surgery but the wound did not heal properly. He was admitted to the Korean Medicine Hospital where his wound, right leg coldness, and phantom pain were treated with combined Korean medicine. The patient was hospitalized again where he underwent micro-drilling surgery. The patient was re-admitted to the Korean Medicine Hospital where he received combined Korean medicine treatment (CKMT) and carbon arc light treatment (CALT) for his wound, leg coldness, stiffness, and hypoplasia. The temperature of his right leg increased, the numeric rating scale score for assessing pain fell from 5 to 1.5, and subjective discomfort was reduced (< 20%) suggesting this may be an effective treatment.

Aortoenteric Fistula - A Report of a Case - (대동맥장루 -1예 보고-)

  • 김성수
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.823-828
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    • 1989
  • Aortoenteric fistula is an uncommon important complication of aortic reconstruction with a prosthetic graft. The complication often is difficult to diagnose and is associated with poor prognosis. Aortoenteric fistula could be divided into true aortoenteric fistula and paraprosthetic-enteric fistula. In case of true aortoenteric fistula, an actual communication between the gastrointestinal tract and the aortic lumen is present. So, massive gastrointestinal hemorrhage is the presenting manifestation. In paraprosthetic-enteric fistula, characterized by communication between the gastrointestinal tract and the external surface of synthetic vascular prosthesis without actual fistularization into the vascular lumen, the predominant clinical manifestation were sepsis, fever and anemia. We experienced one case of paraprosthetic-enteric fistula in a 16 years old male after abdominal aortic reconstruction with a prosthetic graft. The interval from the operation to onset of symptoms was 40 months. The initial clinical manifestation was sepsis, fever and anemia without massive gastrointestinal hemorrhage. Surgical treatment consists of complete excision of infected graft, two layers closure of jejunal wall defect and pledgets suture of aortic stump with surrounding health tissue. Anatomic revascularization was not able to be done: because of extensive retroperitoneal inflammation and extraanatomic revascularization did not performed due to adequate distal blood supply through rich collateral circulation. After operation, he complained numbness on left foot on moderate exertion and felt coldness on left leg compared with right leg but not showed skin color change. 43 days after operation, he discharged without gait disturbance except numbness on left foot on moderate exertion.

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Method of Walking Surface Identification Technique for Automatic Change of Walking Mode of Intelligent Bionic Leg (지능형 의족의 보행모드 자동변경을 위한 보행노면 판별 기법)

  • Yoo, Seong-Bong;Lim, Young-Kwang;Eom, Su-Hong;Lee, Eung-Hyuk
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.11 no.1
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    • pp.81-89
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    • 2017
  • In this paper, we propose a gait pattern recognition method for intelligent prosthesis that enables walking in various environments of femoral amputees. The proposed gait mode changing method is a single sensor based algorithm which can discriminate gait surface and gait phase using only strain gauges sensor, and it is designed to simplify the algorithm based on multiple sensors of existing intelligent prosthesis and to reduce cost of prosthesis system. For the recognition algorithm, we analyzed characteristics of the ground reaction force generated during gait of normal person and defined gait step segmentation and gait detection condition, A gait analyzer was constructed for the gait experiment in the environment similar to the femoral amputee. The validity of the paper was verified through the defined detection conditions and fabricated instruments. The accuracy of the algorithm based on the single sensor was 95%. Based on the proposed single sensor-based algorithm, it is considered that the intelligent prosthesis system can be made inexpensive, and the user can directly grasp the state of the walking surface and shift the walking mode. It is confirmed that it is possible to change the automatic walking mode to switch the walking mode that is suitable for the walking mode.

Use of Expandable Prostheses in Malignant Bone Tumors in Children (소아 악성 골종양의 치료에서 확장형 종양대치물의 이용)

  • Han, Il-Kyu;Lee, Sang-Hoon;Cho, Hwan-Seong;Oh, Joo-Han;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.10-16
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    • 2008
  • With the advent of effective chemotherapy and the realization of high economic cost associated with amputation, limb salvage surgery has become the standard of treatment in children with primary malignant bone tumors. Reconstruction after resection of malignant bone tumors of children has to address the leg length inequality and also has to be durable to cope with high functional demands of young patients. Expandable endoprostheses have been used in children for achieving limb length equality with substantial risk of complications. Recently, significant advances in prosthetic designs have reduced the morbidities associated with these prostheses. The purpose of this study was to review the indications, characteristics, complications and recent developments of expandable endoprostheses used for malignant bone tumors in children.

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Three-Dimensional Finite Element Analysis of Micromotion of the Straight and the Curved Femoral Stem in Cementless Hip Arthroplasty (인공고관절 직선형 대퇴 stem과 곡선형 대퇴 stem의 미세운동비교 - FEM 3차원 모델을 이용한 분석 -)

  • Kim, S.K.;Chae, S.W.;Jeong, J.H.
    • Proceedings of the KOSOMBE Conference
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    • v.1997 no.05
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    • pp.245-248
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    • 1997
  • Excessive stress on the bone-stem interface may cause local micromotion that could produce midthigh pain, interface bone resorption and prevent bony ingrowth. It is important for clinician and prosthetic designer to develop an understanding of the load transfer mechanism, its associated stress pattern and its relationships with the particular mechanical characteristics of the femoral stem designs. Finite element method (FEM) is preeminently suited to provide information in this respect. The authors developed 3-dimensional numerical finite element models implanted with the straight stem which is composed of total 1170 elements of 8 nodes and with the curved stem which is composed of total 885 elements of 8 node, and analysed the relative micromotions between the straight stem and the curved stem in immediate postoperative stage of an uncemented total hip replacement in load simulating the single leg stance. The results showed that the rotational displacement was occupied over 90% of total micromotion in both types of stem and was peak at the proximal medial portion of the stem, but markedly less distally. The curved stem was more stable especially in terms of rotational stability. It is recommended that surgeons do not allow the patient weight bearing until bony ingrowth was achieved. In the future more attention should be drawn to increase initial rotational stability of the two types of femoral stem to prevent loosening from excessive micromotion.

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Functional and Radiological Results of Intermediate-term Follow Up in $MUTARS^{(R)}$ Tumor Endoprostheses ($MUTARS^{(R)}$ 종양 대치물을 이용한 사지 구제술의 기능적 및 방사선학적 중기 추시 결과)

  • Kang, Dong-Joon;Kim, Jeung-Il;Oh, Jong-Seok;Moon, Tae-Yong;Lee, In-Sook
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.1
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    • pp.36-43
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    • 2011
  • Purpose: This study was designed to verify intermediate-term functional and radiological results of limb salvage operation using endoprosthetic replacement system ($MUTARS^{(R)}$) used in patients with a malignant bone tumor. Materials and Methods: Thirty one cases which used $MUTARS^{(R)}$ tumor prosthesis were reviewed. The mean age of the patients was 49.2 years and the mean follow up was 39.8 months. We retrospectively reviewed complications, and evaluated functionally and radiologically by Enneking functional score, ISOLS radiological implants evaluation system at last follow-up. Results: 3 patients had died of disease, distant metastasis was seen in 4 patients and local recurrence was seen in 1 patients. Complications were developed in 12 patients. (infection 6, leg length discrepancy 2, aseptic loosening 2, periprosthetic femoral fracture 1, screw loosening 1) Mean value of total functional scores were 81.2% in proximal femur, 77.4% in distal femur, 78.1% in proximal tibia, and 80.2% in proximal humerus. The overall radiological result was relatively satisfactory. Conclusion: Our results suggest limb salvage with the $MUTARS^{(R)}$ endoprosthesis is successful with good functional and radiological results. But we should be careful with complications such as infection.

Behcet`s Syndrome with Aortic Aneurysm: A Case Report (Bechet`s 병과 합병된 상부대동맥류: 치험 1례 보고)

  • Gang, Jeong-Ho;Lee, Jeong-Ho;Yu, Hoe-Seong
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.98-105
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    • 1977
  • A 36 year old blindman, engineer was admitted with chief complaints of hemoptysis, recurrent sore throat, pyoderma in genital organ, uveitis and thrombophlebitis for 10 years. Above the chief complaints were remission or exacerbation during hospitalization. Physicalexamination showed that left radial, ulnar & brachial pulse was not palpable. No bruit or murmur was obtained over the mass. Neurologic examination revealed no significant finding.On admission, chest P-A showed hen egg sized round & oval compact hazy density on left upper lung field. Bronchogram revealed no pathological finding and Lt. tomogram showed well define large,ovoid mass density in the superior mediastinum. Fluoroscopy finding showed nonpulsatile on left upper lung field. Pre-op. aortography was not taken, under the impression of lung Ca. rule out .sortie aneurysm, exploratory operation was performed through the 2nd intercostal space, Lt. It was performed that the mass was ascending sortie aneurysm of saccular type. Direct aneurysmectomy with multiple figure of eight suture were done without any prosthetic graft. Post-op. control I.V.C graphy showed completely obstruction sign. Postopcontrol aortography revealed good surgical result. Final, histopathological answered non-specific sortie aneurysm, saccular type. Post-op. courses were uneventful except mild neurologic disturbance with subclavian steal syndrome and associated with both lower leg pitting edema due to inferior vena cava obstruction. After op, 3 month later, discharged to home, with big systemic problem. Behcet`s syndrome reviewed with related literatures. The coexistence of mouth and genital ulceration with hypopyon mentioned by hippocrates and described by various workers in the early part of this century was first defined as a syndrome by Behcet in 1937. In 1937 Behcet described a chronic relapsing triple symptom complex of oral ulceration, genital ulceration, and ocular inflammation. The place of the syndrome as part of a systemic disorder in now clearer, and the under lying pathology appears to be a vasculitis. The disease runs a- chronic course, blindness being the greatest disability and control nervous system involvement a cause of death. Thrombophlebitis is fairly frequent, france et al [1951] giving an incidence of 25% and Dowling [1961] 12%, superficial thrombophlebitis migrans and thrombosis of large veins, including venae cavae [Thomas, 1947: Boolukos 1960] are recorded. Little attention has been paid to arterial involvement. Mishima et al. [1961] described resection cf an aortic aneurysm in a 38 year old man with Behcet`s syndorme. Mounsey in a clinicopathological conference described a case [Brit, med. J., 1966] of ruptured aortic aneurysm in Bechcet`s syndrome treated by aorto-iliac graft. Also, Shikano and Oshima et al [1963] recorded two aneyrysm of smaller arteries. Unfrequently, aortic aneurysm was presumed to be secondary to osteomyelitis of the lumber spine, though the possible association between aortic aneurysm and Behcet`s syndrome was raised. A further case is reported here, in which ascending aortic aneurysm with Behcet`s Ds. appeared to form part of this generalized disease. This is a case report of surgical experience of Behcet`s Ds. with ascending aortic aneurysm which had nearly all the typical clinical features. Above mentioned and was reviewed with related literatures.

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