• Title/Summary/Keyword: Salvage operation

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Limb Salvage Surgery after Removal of Infected Tumor Prosthesis with Equalization of Leg Length (감염된 종양 대치물 제거와 하지 단축 보정 후 시행한 사지 구제술 - 증례 보고 -)

  • Kwon, Young-Ho;Kim, Jae-Do;Chung, So-Hak;Cho, Yool
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.141-147
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    • 2006
  • In 1996, a nine-year-old girl was treated with recycling autograft after wide resection of the distal femoral osteosarcoma. The leg lengthening and revision with growing tumor prosthesis were performed due to limb leg discrepancy and epiphyseal problem. However, deep infection developed after operation, and a temporary spacer with cement and Ender nail was inserted. After infection was controlled completely, the final leg lengthening was performed with mono-external fixator for limb length discrepancy (10 cm). Lastly, Tumor prosthesis was reinserted to preserve the joint function.

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Free Flap Salvage in the Ischemic Foot: A Case Report

  • Seo, Dongkyung;Dannnoura, Yutaka;Ishii, Riku;Tada, Keisuke;Kawashima, Kunihiro;Yoshida, Tetsunori;Horiuchi, Katsumi
    • Archives of Plastic Surgery
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    • v.49 no.5
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    • pp.696-700
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    • 2022
  • We performed distal bypass and free flap transfer in a single-stage operation to repair an extensive soft tissue defect in an ischemic foot of an 84-year-old woman. The nutrient artery of the free flap was anastomosed to the bypass graft in an end-to-side manner. Subsequently, the bypass graft became occluded on several occasions. Although intravascular and surgical interventions were performed each time, the bypass graft eventually became completely occluded. However, despite late occlusion of the nutrient artery, the free flap has remained viable and the patient is ambulatory. The time required for a transplanted free flap to become completely viable without a nutrient artery is likely longer for an ischemic foot compared with a healthy foot. However, the exact period of time required is not known. A period of month was required in our patient. We report this case to help clarify the process by which a free flap becomes viable when applied to an ischemic foot.

Long Term Follow-up of Avascular Necrosis after Talar Fracture and Dislocation: 5 Cases (거골 골절 탈구 후 무혈성 괴사의 장기 추시: 5예)

  • Kim, Byung-Cheol;Choi, Sung-Jong;Kim, Hui-Taek;Yoo, Chong-Il;Jung, Sung-Won;Eun, Il-Soo;Ku, Jeong-Mo;Kim, Jong-Kyun
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.31-37
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    • 2005
  • Purpose: To report our opinions of management about avascular necrosis following operative treatment of talar fracture and dislocation. Materials and Methods: We followed up 5 patients who were diagnosed as talar avascular necrosis after operation of talar fracture and dislocation. Clinical and radiological analysis were performed. The mean age of patients was 36 years. There were 4 males and 1 females. The average follow up was 51 months. Hawkins scoring system was used as clinical evaluation. Results: Regardless of radiological sclerotic finding, all patients showed satisfactory clinical result. Despite arthritic change in one patient, there were no further radiological and clinical deterioration to require salvage procedure. Conclusion: Most avascular necrosis after operative treatment of talar fracture and dislocation showed satisfactory result with conservative treatment. Thus, salvage operation such as talectomy or ankle fusion should be reserved in cases of intractable ankle pain and claudication.

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Partial Resection of Osteosarcoma in Proximal Tibia - A Case Report - (근위 경골 골육종의 부분 절제술 - 증례 보고 -)

  • Song, Won-Seok;Lee, Seung-Jun;Won, Ho-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.140-145
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    • 2008
  • After limb salvage operation becomes popular, reconstruction method of epi-metaphyseal osteosarcoma is relatively standardized though it may be operator's matter of preference. Most limb salvage techniques presently used are prosthesis reconstruction and osteoarticular allograft. In the case of prosthesis, it is very stable and shows good postoperative functional score, however, finally, it has a weak point of requirement for removal procedure due to failure. In the long run, allograft reconstruction has a good merit. But, it has a weak point of difficulties in securing the demanded size and shape. Allograft reconstruction should be performed only in the case of safe margin and established indication. In limb salvage operation, intercalary reconstruction is useful method in diaphyseal osteosarcoma, however, in metaphyseal osteosarcoma, the indication is not confirmed. We treated 17 year old osteosarcoma patient with localized in the tibial medial condyle with proximal medial condylectomy and pasteurized bone reconstruction in the conviction of safe surgical margin. We report this case because we guess if this procedure may be applied to premature patients, despite failure hemiarthroplasty can be tried successfully.

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A Study on the Introduction and Application Plan of the Mobile Saturation Diving System for ROK Navy Salvage Operations (한국 해군의 해난구조작전을 위한 이동식 포화잠수체계 도입 및 활용방안에 관한 연구)

  • Yu, Ho-Hwi;Kang, Sin-Young;Lim, An
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.21 no.4
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    • pp.389-396
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    • 2015
  • This study examined how to improve the Korean Navy diving system, particularly focused on using the mobile saturation diving system. This study determined the range of navy operations, and suggested requirements of mobile saturation diving system from the analysis of previous study and current Navy Diving system. Also, this study examined the use of military strategy in terms of its technical and applicable possibility for the enhancement of current system. In addition, the study analyzed both advantages/disadvantages of importing mobile saturation diving system products and domestic development. To review measures in installing and operating such system, this study included analysis on the effectiveness of individual platform. As the result, the study suggested requirements of mobile saturation diving system to be able to be operated by more than 6 divers for more than 17 days at more than 200m depth. And the study confirmed that there are beneficial to use mobile saturation diving system and current Navy saturation diving system together. However, it is low economical efficiency to change current Navy gas diving system to Saturation diving system. To review measures in installing and operating such system, this study suggested that second ATS-II should be built to be able to install mobile saturation diving system. Also, this study generated an utilization method of the system to use it for training when peacetime, and than it should be installed on other platform to use as additional salvage strength during wartime.

Functional Result of Limb Salvage Surgery with Tumor Prosthesis for Osteosarcoma of Proximal Tibia (근위 경골 골육종의 종양대치물을 이용한 사지 구제술 후의 기능 평가)

  • Bahk, Won-Jong;Sohn, Jong-Min;Chung, Yang-Guk;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.4
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    • pp.139-143
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    • 2001
  • Purpose : Limb salvage for osteosarcoma of proximal tibia is challenging problem due to difficulties in mobilizing or retracting the main neurovascular structure, inadequate soft tissue coverage, and unsolved problem of patellar tendon reattachment to endoprosthesis. The authors analyzed the functional result of limb salvage using tumor prosthesis with medial gastrocnemius rotation plasty for osteosarcama of the proximal tibia. Materials and Methods : Eleven patients with histologically proven osteosarcoma of the proximal tibia, treated with adjuvant and neoadjuvant chemotherapy and limb salvage operation with tumor prosthesis between January 1992 and December 1998 at our Medical Center, were selected. There were 6 male and 5 female. Age ranged from 15 years to 23.7 years with an average of 23.7 years. Follow-up period ranged from 1 year to 4.5 years with an average of 2.5 years. The final functional result was evaluated using the method by ISOLS, 1993. The factors include pain, functional activities, emotional acceptance, use of external supports, walking ability and gait. Each of the factors has been scored from 0 to 5 depending on the appropriate description or data. The rating score is determined by dividing the individual factor scores into the total score and indicates percentage of normal function. Results : The overall functional result ranged from 53,3% to 86.7% with an average of 68.3% of normal function. In details, the averages were 82.5% for pain, 62.5% for functional activities, 67.5% for emotional acceptance, 77.5% for use of external supports, 62.5% for walking ability, and 57.5% for gait. The average range of motion of the knee joint was $5^{\circ}$ extension and $85^{\circ}$ flexion. Five patients have extension lag ranged from $5^{\circ}$ to $15^{\circ}$ with an average of $10^{\circ}$. Two patients suffered postoperative infection. One was treated with antibiotics injection only, but the other needed removal of the prosthesis and knee fusion. Both of them showed unsatisfactory result. C o n c l u s i o n : The overall functional result after limb salvage using tumor prosthesis with medial gastrocnemius rotational flap for osteosarcoma of the proximal tibia was relatively satisfactory in case of no postoperative infection. The patients were less satisfactory in functional activities, emotional acceptance and gait than pain, use of external supports due to limitation of motion and extension lag. More aggressive postoperative physical therapy and protection with brace for 6~9 months as well as surgical technique is mandatory for more satisfactory result.

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Atypical Extraventricular Neurocytoma

  • Choi, Hyun-Ho;Park, Sung-Hye;Kim, Dong-Gyu;Paek, Sun-Ha
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.381-384
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    • 2011
  • The authors report a case of atypical extraventricular neurocytoma (EVN) transformed from EVN which had been initially diagnosed as an oligodendroglioma 15 years ago. An 8-year-old boy underwent a surgical resection for a right frontal mass which was initially diagnosed as oligodendroglioma. When the tumor recurred 15 years later, a secondary operation was performed, followed by salvage gamma knife treatment. The recurrent tumor was diagnosed as an atypical EVN. The initial specimen was reviewed and immunohistochemistry revealed a strong positivity for synaptophysin. The diagnosis of the initial tumor was revised as an EVN. The patient maintained a stable disease state for 15 years after the first operation, and was followed up for one year without any complications or disease progression after the second operation. We diagnosed an atypical extraventricular neurocytoma transformed from EVN which had been initially diagnosed as an oligodendroglioma 15 years earlier. We emphasize that EVN should be included in the differential diagnosis of oligodendroglioma.

Development of the Ship Resistance Calculation Program for Prediction of Towing Forces for damaged Ships (손상 선박의 예인력 추정을 위한 선박 저항 계산 프로그램 개발)

  • Choi, Hyuek-Jin;Kim, Eun-Chan
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.15 no.2
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    • pp.150-155
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    • 2012
  • One of the primary purposes of tugs is for the towing of other ships in salvage operations. In order to conduct such a task safely, the tug should be capable of generating the appropriate towing forces. Therefore the prediction of resistance against a towed ship during towing operation is a very important and essential procedure. This paper studies the ship resistance calculation program to predict towing force. The calculation program consists of the functions that calculate basic hull resistance in calm water, added resistance due to wind, drifting, hull roughness, waves, shallow water and currents. All predictions are calculated by statistical and empirical methods by graph or formula. The calculation results made by this program are compared with the results from the U.S. Navy's Towing Manual. These results confirm that this computer program is quite capable of appropriately predicting the resistance of damaged ships.

Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review

  • Tsung-Chun Huang;Jian-Jr Lee;Kuo-Hui Yang;Chia-Huei Chou;Yu-Chen Chang
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.557-562
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    • 2023
  • Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique "transaxillary capsulorrhaphy" to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.

Radiologic Evaluation of Limb Salvage Operation with Tumor Prosthesis (종양 대치물을 이용한 사지 구제술의 방사선학적 평가)

  • Moon, Sang-Ho;Lee, Sang-Hoon;Kim, Han-Soo;Oh, Joo-Han;Ko, Byung-Won;Koo, Ki-Hyung;Lee, Jae-Hag;Hwang, Chung-Soo;Lee, Han-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.4
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    • pp.152-162
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    • 2000
  • Purpose : To verify radiological changes of limb salvage operation using tumor prosthesis. Materials and Methods : Sixty-nine cases which used tumor prosthesis were reviewed. They have been followed up for average four years and nine months. We evaluated radiographs by ISOLS(International Symposium On Limb Salvage) radiological implants evaluation system immediate postoperatively, at postoperative 1 year and last follow-up. After converting 'excellent, good, fair, poor' to '4, 3, 2, 1' for stastical analysis, data were analyzed according to the use of cement, anatomical sites, diagnosis implant designs and age (<20 year vs. ${\geq}$20 year) using t-test and ANOVA. Results : The outcomes of cemented type prostheses were superior in remodelling and interface but inferior in anchorage. The scores of proximal femur and distal tibia were worse in bone remodelling. Osteosarcoma group had lower scores in anchorage and implant articular problem. There were no significant differences according to four different implant designs and age. Conclusion : In the intermediate term follow-up radiological evaluation, cemented type prosthesis were better in the aspects of bony resorption and osteolysis, and cementless one in anchorage. Distal femur and proximal tibia have higher scores in bony resorption, and osteosarcoma was worse tumor entity in anchorage and articular problem, and chemotherapy may be the cause.

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