• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.252-255
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• 2018

A 51-year-old male who is right-handed visited the outpatient for right fingers-drop. The patient's fingers, including thumb, were not extended on metacarpophalangeal joint. The active motion of the right wrist was available. The electromyography and nerve conduction velocity study were consistent with the posterior interosseous neuropathy. Further evaluation was done with the magnetic resonance imaging for finding the space-occupying lesion or any possible soft tissue lesion around the radial nerve pathway. On magnetic resonance imaging, the ganglion cyst, which was about 1.8 cm in diameter, was observed on the proximal part of the superficial layer of the supinator muscle (Arcade of Frohse). The surgical excision was done on the base of ganglion cyst at the base of stalk of cyst which looked to be connected with proximal radioulnar joint capsule. The palsy had completely resolved when the patient was observed on the outpatient department a month after the operation.

• The Journal of the Korean dental association
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• v.52 no.10
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• pp.615-622
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• 2014

Oral cancer ablation surgery results in tissue defects with functional loss. Accompanying neck dissection results in facial nerve weakness and dysmorphic changes. To minimize the complications after oral cancer surgery, accurate dissection without damaging facial nerve and vital structures are mandatory. Marginal mandibular branch of facial nerve should be dissected or contained in the superficial layer of deep cervical fascia to minimized facial palsy after operation. Reconstruction after cancer ablations is routine procedures and free flap reconstruction is the most commonly used. Radial forearm free flap is the most versatile flap to reconstruct soft tissue defects and it is easy to design according to the defect size and shape. However, donor site scar and secondary skin graft from thigh result in unesthetic and cumbersome wounds. Double layered collagen graft in the donor site could reduce secondary donor site for skin graft. In conclusion, oral and maxillofacial surgeon should know the exact anatomy of the face and neck during neck dissection. Radial forearm free flap is most versatile flap for soft tissue reconstruction and double collagen graft can reduce postoperative scar and there is no need for secondary skin graft.

• Archives of Reconstructive Microsurgery
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• v.8 no.1
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• pp.15-21
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• 1999

Soft tissue defect on heel area of the foot present difficult problems particularly because of anatomic property of plantar surface of the foot. There is a paucity of available local tissue in the foot for coverage. In addition to having little expandable tissue, the foot's plantar surface has a unique structure, making its replacement especially challenging. Plantar skin is attached to the underlying bone by fibrous septa, preventing shear of the soft-tissue surfaces from the underlying skeleton. Plantar surface of foot is in constant contact with the environment. Protective sensibility also would be maintained or restored in the ideal reconstruction. So the ideal flap for reconstruction of the heel should include thin, durable hairless skin with potential for reinnervation. The aim of this article is to present a clinical experience of free lateral arm neurosensory flap for reconstruction of the heel. From March 1995 to December 1997, a total 16 lateral arm free flaps were performed to soft tissue defects on the weight-bearing area of the hindfoot. we used tibial nerve as recepient nerve in 11 and calcaneal branch of tibial nerve in 5 for restoration of sensibility of flap. All cases survived completely. A static two-point discrimination of 14 to 34mm was detected in the flap. Radial nerve palsy which was caused by hematoma in donor site occured in one case, but recorverd in 3 weeks later completely. In conclusion, the lateral arm free flaps are versatile, reliable and sensible cutaneous flap and especially indicated for soft tissue defect on plantar surface of the hindfoot which are not good indications for other better-known flaps.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.235-241
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• 2006

Neglected adult Monteggia fracture could induce the pain, instability and malformation of elbow. Especially, compared with the chronic Monteggia fracture of child, that of adult is difficult to treat and could concur with valgus instability and deformity, limitation of range of motion and tardy ulnar nerve palsy. But recently, the chronic Monteggia fracture of adult could be treated by the 3.5 mm compression plate (DCP) or 3.5 mm pelvic reconstruction plate, so that the result improved more and more. The treatment of choice of the chronic Monteggia fracture of adult is the corrective osteotomy and reduction of radial head or resection of radial head. We experienced two patients who had neglected Monteggia fracture over 1 year 6 months and 25 years respectively and we want to report the result of surgical treatment of chronic Monteggia fracture of adult.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.50-59
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• 2006

Purpose: The nonoperative outcome of elbow dislocations with associated radial head and coronoid fractures are often unsatisfactory because of chronic instability and stiffness from proloned immobilization, Therefore we managed these injuries with well programed surgical appproaches. Method: Ten patients with this injury were evaluated retrospectively from May 1998 to June 2004 after a minimum of 12 months. These injuries include elbow dislocation and associated fractures of both the radial head and the coronoid process. All ten patients were treated by one clinic operatively with similar scheduled surgical methods which started on the lateral side and terminated on the medial side of the elbow. Radial head and neck fractures were classified Mason types, as two and three types respectively with six and four cases and six cases were fixated. Coronoid process were fixated with screws anteroposterior directly or anchor suture in all cases, each type was classified one, two and three. where were three type one, four type two, and three type three were according to Regan and Morrey classification. Results: The outcome was three resulting in excellent, four good, two normaland and the remaining case was one poor according to the Mayo Elbow Performance score. At a terminal follow up, the range of motion of the elbow averaged flection contracture, $6^{\circ}(0{\sim}20^{\circ})$ and further flection, $129^{\circ}(115{\sim}140^{\circ})$. Two patients had complications requiring additional care. One, displaced coronoid process which was repaired with capsule and the other patient experienced, palsy of ulnar nerve and contracted elbow joint. Conclusions: Usage of early operation as the minimum injury of medial ligaments complex and the rigid fixation of fractures to prompt motion with our scheduled management for elbow dislocations with associated radial head and coracoid fractures provided excellent results.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.4
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• pp.55-65
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• 2017

Objectives The purpose of this review is to analyze results of case studies and controlled studies about Carthmi-Flos pharmacopuncture. Based on the review, authors desire to suggest the study model including precise information and evident the effect of Carthmi-Flos pharmacopuncture objectively in treating clinical disorders. Methods We search 44 studies about Carthmi-Flos pharmacopuncture from 6 Korean web databases, using words 'Carthmi-Flos pharmacopuncture' in Korean alphabet. This study had been conducted throughout 1 month (July, 2017). We selected case studies and controlled trials in investigated 44 thesis, excluding experimental research and thesis not using the Carthmi-Flos pharmacopuncture for major treatment. Results We analyze 13 case reports and 7 controlled trials. As a result, Carthmi-Flos Pharmacopuncture was used mostly in musculoskeletal, neurological diseases. But this can be applied to internal diseases. Disorders reported effectively were carpal tunnel syndrome, degenerative knee joint arthritis, posterior neck pain, low back pain, radial nerve palsy, shoulder pain, lumbar compression fracture, alopecia areata, chronic daily headache, duverney fracture, oligomenorrhea, cervical disc herniation, rheumatoid arthritis and cervical headache. Conclusions As we analyzed, Carthmi-Flos pharmacopuncture is specifically effective in musculoskeletal and neurologic diseases. But there are various problems in study design. To design accurately, the study design should include much more specific information. And the result can be more precise by excluding other methods.

• Clinics in Shoulder and Elbow
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• v.18 no.2
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• pp.75-79
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• 2015

Background: This retrospective comparative study aims to evaluate the surgical outcomes and complications of two surgical methods for simple fractures of the humeral shaft; minimally invasive anterior plating and open reduction combined with internal fixation. Methods: A total of 26 patients with humeral shaft simple fractures, who had surgery between June 2009 and September 2013 and were followed-up at least 12 months, were included in our analysis. They were divided into two groups; group 1 comprised of 12 patients who underwent minimally invasive anterior plating and group 2 comprised of 14 patients who underwent an open reduction and internal fixation. The clinical outcomes, radiological results, and complications were compared and analyzed. Results: We found that bone union was achieved in all patients, and the mean union periods were $20.7{\pm}3.34$ and $20.3{\pm}3.91$ weeks for groups 1 and 2, respectively. In most patients, we found that shoulder and elbow functions were recovered. At 12 months post-operation, we found that the Korean Shoulder Scoring system, the University of California at Los Angeles score and Mayo elbow performance score were $91.4{\pm}7.97$, $33.4{\pm}1.15$, and $90.8{\pm}2.23$ for group 1, and $95.2{\pm}1.53$, $33.3{\pm}1.43$, and $90.17{\pm}1.85$ for group 2. In terms of complications, we found that 2 patients had radial nerve palsy after open reduction and internal fixation, but all cases spontaneously resolved within 6 months. Complications such as infection and loss of fixation were not reported. Conclusions: Both minimally invasive anterior plating and open reduction with internal fixation produced satisfactory outcomes in the treatment of simple fractures of the humeral shaft.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.73-82
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• 2013

Objectives The purpose of this review is to investigate studies of Scolopendrid pharmacopuncture and the evidence of it's effects in order to suggest a better research method in the future. Methods We retrieved numbers of clinical studies about Scolopendrid pharmacopuncture from 7 Korean web databases, using key words such as 'Scolopendrid', 'Scolopendrid AND Pharmacopuncture'. This study had been conducted from 1st May 2013 to 31th July 2013. Controlled studies and case studies were only used for this study. Clinical studies that we picked from the databases were classified according to the diseases that those studies are about, and from these clinical studies, we are to research what has to be improved generally in clinical researches. Results 18 case studies, 4 controlled studies had been under research. Scolopendrid pharmacopuncture has a therapeutic effect mainly in musculoskeletal and neurological diseases such as herniated intervertebral disc, carpal tunnel syndrome, swollen leg, feeling of cold on legs, wrist ganglion, lateral epicondylitis, radial nerve palsy, cervical myelopathy, cauda equina syndrome, postauricular pain; as an early symptom of Bell's palsy, pain of popliteal part, gout, plantar fasciitis, cellulitis, frozen shoulder, pain of hip adductors. However objectivity and reliability of the Scolopendrid pharmacopuncture studies still remains controversial. Conclusions It has been suggested that there are positive effects of Scolopendrid pharmacopuncture therapy in treating specific diseases (especially neuromusculoskeletal diseases). However, this narrative review can't conclude and prove that the Scolopendrid pharmacopuncture has positive effectiveness on these diseases unlike systematic review. So, in order to put Scolopendrid pharmacopuncture therapy to use for many kinds of diseases in more reasonable ways, it is essential to build well-designed clinical research tools. In the future, abundant case studies, more follow-up trials and randomized controlled trials based on the korean medicine should be done to use Scolopendrid pharmacopuncture for a clinical purpose.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.230-236
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• 2010

Purpose: We wanted to evaluate the result of percutaneous, mini-open reduction for the treatment of Mason II or III radial head and neck fractures. Materials and Methods: 13 patients (8 male, 5 female) with Mason II or III radial head and neck fractures were treated by 1 cm percutaneous mini-open reduction under fluoroscopy. The average age of our subjects was 29 years. Follow up duration was 18 months. Results: Union was noted in all cases. Mean radial neck angulation was decreased from 33.2 degrees to 7.8 degrees. The mean change in angulation between the immediate post-operative and last follow-up was 0.7 degrees. The mean range of motion at the elbow joint was at last follow up, 133.1 degrees in flexion, 7.3 degrees in extension, 80 degrees in pronation and 84.3 degrees in supination. Postoperatively, mean Mayo Elbow Performance Index, American Shoulder and Elbow Surgeons elbow score, and Disabilities of the Arm, Shoulder and Hand score were 96.2, 97 and 1.2. Temporary posterior interosseous nerve palsy (1 case) and minimal cubitus valgus deformity (1 case) were noted. Conclusion: Selected Mason II or III radial head and neck fractures can be treated satisfactorily with percutaneous mini-open reduction.

• The Journal of the Korean bone and joint tumor society
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• v.8 no.3
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• pp.96-105
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• 2002

Purpose: The purpose of this study was to assess the oncologic results and functional outcomes of limb salvage surgery performed in patients of primary bone tumors of the shoulder girdle. Materials and Methods: Twenty-nine patients who underwent limb sparing resection for shoulder girdle neoplasm between 1982 and 2001 were analyzed. Follow up periods averaged 7 years and 1 month. Mean age of the patients was 35 (11~71) years. There were 14 males and 15 females. Primary malignant bone tumors of shoulder girdle (proximal humerus 21, scapula 3, both 1) were 23 cases; osteosarcomas 7, chondrosarcoma 14, parosteal osteosarcoma 1, hemangioendothelioma 1, and giant cell tumor of proximal humerus were 6 cases. Limb salvage surgery was performed by curettage and cementing in 7 patients, by cement molding arthroplasty in 10 patients, and by tumor prosthesis in 7 patients, by other method such as resection only, bone graft, arthrodesis in 5 patients. The Musculoskeletal Tumor Society functional rating system was used to assess functional outcomes. Results: One osteosarcoma and 2 chondrosarcoma patients died, and the survival of the salvaged limb was 88.6% at the final follow-up. There were 6 local recurrences, 2 lung metastases, 2 local recurrences and lung metastases. The functional outcome was 80%. There was statistically significant difference of functional results among the patients treated by cement filling (86%), cement molding arthroplasty and IM nailing (71%), and tumor prosthesis (83%). (p=0.034) There were three complications including 1 radial nerve palsy and 1 axillary nerve palsy, and 1 wound infection. Dislodgement of vascularized fibular graft in one patient was treated by internal fixation. Conclusion: Limb salvage surgery seems to be useful method to treat bone tumors of the shoulder girdle.