• Archives of Plastic Surgery
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• 제34권4호
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• pp.516-519
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• 2007

Purpose: Hemophilia is one of the most common bleeding disorder, and circulating levels of factor VIII or IX are closely related to the severity and frequency of the bleeding. The severity of hemophilia is classified to be severe, moderate, and mild when the factor level is less than 1%, between 1% and 5%, and between 5% and 25%, respectively. Hemophilic pseudotumor is a rare complication occurring in 1 - 2% of patients with factor VIII or IX deficiency. If the treatment is delayed, it would cause disabling and life threatening results. Methods: We experienced hemophilic pseudotumor developed at the fracture site of the proximal phalanx of the hand in a hemophilic B patient. Hemophilic pseudotumor was successfully treated with perioperative factor replacement and surgical intervention included excision and autologous bone graft. Results: Hemophilic pseudotumor was healed with complete regression, and no specific complication was developed. Conclusion: When we accounter hematoma like lesion after surgery unpredictably, we must consider hemophilic pseudotumor and make a accurate diagnosis with preoperative hematologic screening and various imaging study. Subsequently, adequate perioperative supplement of concentrate and surgical intervention brings to the satisfactory result without recurrence.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.64-67
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• 2011

Reconstruction of the distal portion of the great toe has always represented a difficult problem to surgeons. There are many methods of flap reconstruction described for foot defects, but none for tip of the great toe. We report a case of reconstruction of the great toe using a homodigital reverse pedicle island flap method. A 25-year-old man had a crushing injury at the distal phalanx of the left great toe. A homodigital reverse pedicle island flap was raised from the dorso-medial aspect of the proximal phalanx of the great toe based on the distal dorsal arcade. The flap covered the exposed distal phalanx and stump was closed without shortening. He made an uncomplicated recovery and when seen 6 months later he had a good cosmetic and functional result. A homodigital reverse pedicle island flap is described for the reconstruction of the distal part of the great toe. It involves only a single stage procedure with minimal donor site morbidity and provides a good cosmetic results.

• 대한족부족관절학회지
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• 제15권3호
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• pp.149-152
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• 2011

Purpose: The Akin osteotomy which is a closing wedge osteotomy of the proximal phalanx widely used for the correction of hallux valgus has several methods of fixation. we tried to report the effects of the fixation using an absorbable suture material during the Akin osteotomy for the hallux valgus. Materials and Methods: This study was based on 448 cases of 346 patients who were able for follow-up more than 12 months among the patients who had an Akin osteotomy together with the surgery of hallux valgus between March of 2006 and May of 2010. Absorbable suture material had been used in all cases. Radiologically displacement and union of osteotomy site were observed after the surgery, and clinically postoperative complication such as skin irritation, pain and satisfaction were investigated. Results: Radiologically all cases had showed complete union and no case had the loss of an correction due to loss of fixation. Also, any case had no skin irritation due to a knot. Three cases had a medial cortical breakage due to a strong knot, and the initial one case among them had additionally fixed the osteotomy site for four weeks using K-wire, and the remaining two cases had fixed a suture on an articular surface without any fixation of an additional wire. If a medial cortical bone was lost by carrying out an ostectomy due to proximal protrusion of proximal phalanx, three cases could show union through the fixation of suture on an articular surface. Conclusion: This study considers that the fixation of the osteotomy site using an absorbable suture material in an Akin osteotomy was effective method and the advantage of this procedure was unnecessity of the material removal and no skin irritation.

• 대한족부족관절학회지
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• 제19권4호
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• pp.197-200
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• 2015

The Akin osteotomy is a complimentary procedure in hallux valgus surgery. Surgical techniques may vary depending on the operators or fixation devices. Suture fixation, for which a removal procedure is not necessary, can often be recommended. However, there is a risk of failure due to the thin cortex of the phalanx. We describe a new technique using Ethibond suture fixation in Akin osteotomy, which can lower the risk of phalangeal cortical failure and articular cartilage irritation. First, the Akin osteotomy was performed on the proximal phalanx 5 to 6 mm distal to the first metatarsophalangeal joint. Then bone holes were drilled from dorsum to plantar parallel to osteotomy with the Kirschner wire. The final procedure involved passing the Ethibond sutures connected to a straight needle through the holes and tying it. This fixation method offers an effective and easy technique for performance of Akin osteotomy.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.118-125
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• 2024

Tamai zone 4 replantation, defined as the replantation at a level proximal to the flexor digitorum superficialis' insertion and distal to where the common digital artery branches into the proper digital artery, has poor functional results because making orthosis and rehabilitation protocols that protect the bone and the flexor and extensor tendons simultaneously difficult. Two cases of Tamai zone 4 replantation are presented: one case of an index finger replantation at the proximal phalanx and a case of ring finger replantation at the proximal interphalangeal joint. The author did not repair the flexor tendon intentionally in the primary replantation and performed two-stage flexor tendon reconstruction later. The total active motions (TAMs) at the last follow-up were 215 and 180 degrees, respectively, with the latter distal interphalangeal joint being an arthrodesis. Both cases had no extension lag in the proximal interphalangeal joint. These results were much better than those in previous reports, in which the mean TAM was 133 degrees or less. The good results appeared to be mainly due to the reasonable and clear postoperative rehabilitation protocols made by the proposed procedure. This procedure may be useful for obtaining reproducible functional results even in Tamai zone 4 replantation.

• 대한수의학회지
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• 제51권4호
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• pp.297-301
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• 2011

The racehorses that under arthroscopic surgery due to be injured his limbs were studied during exercise or training at Busan Race Park from 2005 to 2010. Rate of arthroscopic surgical treatments was 1.4% (63/4,642). Affected bones were radius, radial carpal bone, third carpal bone, proximal phalanx, third metacarpal bone, femur, tibia, proximal sesamoid bone and intermediate carpal bone. The lesions were fracture, chip fracture, slap fracture, osteochonrosis, and osteochondrotitis dissencans. Number of patients under arthroscopic surgery were 63. Success horses of returned to racetrack or tried to return to racetrack were 58, and 5 horses were in training or resting at the time of publication. Success horses of returned to their previous use in the patients were 49 horses (84.4%) and no returned to the racetrack were 9 horses (15.6%) in 58 horses.

• 대한족부족관절학회지
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• 제21권2호
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• pp.43-49
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• 2017

Hallux valgus is a deformity characterized by lateral deviation of the great toe and medial deviation of the first metatarsal. When planning an operative treatment, it is important to realize that the deformity is tridimensional and diverse. Operative techniques include medial eminence resection, distal soft tissue procedure, first metatarsal osteotomy (distal, diaphyseal, proximal, or multiple), proximal phalanx osteotomy, arthrodesis (first metatarsophalangeal or metatarsocuneiform joint), and so on. Among these techniques, osteotomy is the main procedure for correcting the hallux valgus. The objective of this article is to describe the characteristics and recent advancements made for corrective osteotomies in the hallux valgus. The pathophysiology of the hallux valgus is also described.

• 대한골관절종양학회지
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• 제6권1호
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• pp.30-34
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• 2000

수부 및 족부의 작은골에 발생하는 거대세포종은 매우 드물다. 이러한 부위에 발생하는 거대세포종은 비교적 젊은 나이에 다발성으로 발생하며, 장골에 발생하는 거대세포종보다 재발율이 높다. 또한 수부에 발생하는 거대세포종은 내연골증, 동맥류성골낭종, 거대세포수복성육아종 등과 감별하여야 할 것이다. 저자들은 좌측 수부에 부종과 동통을 동반하는 거대세포종을 경험하여 소파술과 골 이식을 수행하였다. 조직학적 검사에서 단핵구가 주로 분포되어 있는 부위에 많은 수의 거대세포가 미만성으로 분포되어 있었고 이차적으로 동맥류성 골낭종과 출혈이 동반되었다.

• 대한골관절종양학회지
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• 제17권2호
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• pp.91-94
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• 2011

기괴성 방골성 골연골성 증식증은 수부와 족부의 단관골의 표면에 발생하는 양성 종양이다. 치료는 일반적으로 변연부 절제술을 시행하지만 절제 후 국소적인 재발을 잘한다. 국내에서는 족부에 발생한 기괴성 방골성 골연골성 증식증에 대한 보고가 극히 드물다. 저자들은 44세 여자 환자에서 우측 제3족지의 근위지골에 발생한 기괴성 방골성 골연골성 증식증을 경험하고 이를 보고하고자 한다.

• The Journal of Korean Physical Therapy
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• 제24권4호
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• pp.276-281
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• 2012

Purpose: The purpose of this study is to compare the kinematic motion of the first metatarsophalangeal (MTP) joint during an electrical stimulation of abductor hallucis (AbdH) muscle, between the normal group and the hallux valgus (HV) group. Methods: A total of twenty subjects (normal group=10 and HV group=10) participated in this study. The kinematic motions of first MTP joint was measured by using 3-dimensional motion analysis during an electrical stimulation in the sitting position. The intensity of an electrical stimulation was set to be tolerated in each subject, and the data of kinematic motions were collected in three trials of 5 seconds. An independent t-test was used to compare the angle of flexion and abduction of the first MTP joint and proximal phalanx in frontal plane, between the normal and HV groups. Results: Participants showed that the angle of flexion was significantly greater in the HV group ($13.12{\pm}10.61^{\circ}$), compared to that of the normal group ($10.17{\pm}2.31^{\circ}$); and the angle of abduction was significantly smaller in the HV group ($10.61{\pm}4.99^{\circ}$) than that of the normal group. Also, the angle of the proximal phalanx in frontal plane was significantly smaller, compared to the normal group ($53.42{\pm}10.70^{\circ}$) (p<0.05). Conclusion: These findings suggest that dysfunction of AbdH muscle is apparent in HV deformity and provide insight into potential risk factors for the development of HV deformity.