• 제목/요약/키워드: Soft tissue reconstruction

검색결과 510건 처리시간 0.029초

만성 아킬레스건 파열의 수술 전략 (Reconstructive Strategies for Chronic Achilles Tendon Rupture)

  • 조병기;안병현
    • 대한족부족관절학회지
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    • 제25권2호
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    • pp.80-88
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    • 2021
  • Chronic Achilles tendon rupture is likely to result in functional impairment in gait and sports activity. The presence of a large defect secondary to retraction of the tendon ends, atrophy of the calf muscles, and vulnerable vascularity of the soft tissue envelope make it a challenging problem to treat. Surgical reconstruction aims to restore the length and tension of the gastrocnemius-soleus complex. Various surgical treatment options have been described, depending on several factors, including residual gap size after scar tissue removal, remaining tissue quality, and vascularity. Despite good results being reported, there is a lack of high-level, evidence-based clinical guidelines available to select the first-line surgical procedure. This paper overviews the current available surgical options for patients with chronic Achilles tendon rupture.

슬관절 주변의 광범위한 연부조직 결손 시에 시행한 광배근-부견갑 피판을 동시에 사용한 유리 피판술의 효과 (Reconstruction of the Large Soft Tissue Defects around Knee Joint with Para-Scapular and Latissimus Dorsi Myocutaneous Free Flap based on Subscapular Vessels)

  • 정덕환;이재훈
    • Archives of Reconstructive Microsurgery
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    • 제11권1호
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    • pp.11-18
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    • 2002
  • Large soft tissue defects around the knee joint are known to significantly diminish joint function. Severe soft tissue defects on the anterior aspect of the knee joint especially bring on significant joint motion limitation. Although simple split skin grafts can cover the skin defect, the progressing scar contracture of the grafted skin causes joint stiffness. One of the best solutions of large soft tissue defects around the knee joint is covering the defect with a good quality skin flap. Separated flaps with one vascular pedicle are good candidates for covering anterior and posterior aspects of the joint for example. Authors performed 12 cases of combined scapular and latissimus dorsi free flaps from 1984 to 2000. Among them, we experienced 5 cases of knee joint defect covering using the double free flap for coverage of the soft tissue defect with preservation of the knee joint function and satisfactory results. The system of flaps based on the subscapular artery and vein provides a variety of composite free flaps. The possible flaps that can be harvested based on this single vascular pedicle include the scapular and parascapular skin flap, the serratus anterior and latissimus dorsi muscular flap, the lateral scapular bone flap, the latissimus dorsi-rib flap, and the serratus anterior-rib flap. This combined flap is available for multiple tissue defects or complex defects because it can be incorporated with skin, muscle and bone flaps. A main advantage is the independent vascular pedicles of each component, which allow freedom in orientation of each components. Consequently it can be freely applied to any form of three dimensional defects on the upper and lower extremities. The combination of scapular cutaneous flap and latissimus dorsi musculocutaneous flap can be resurfaced for massive cutaneous defects on the extremities. We report the use of the combined scapular and latissimus dorsi free flap in five patients to reconstruct massive defects on the extremities with resultant improved joint function. There was no flap failure and minimal complications and disadvantages. The anatomy of this flap is reviewed and the indication and advantages are discussed. All of the five flaps survived and there was no scar contracture affecting the joint motion.

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흉벽에 발생한 유건종 절제후 흉벽 재건술 -1례 보고- (Chest Wall Rreconstruction after Desmoid Tumor Resection -1 Case Report-)

  • 김병균
    • Journal of Chest Surgery
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    • 제28권11호
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    • pp.1075-1078
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    • 1995
  • The desmoid tumor has been reported as the most common histologic subtype of soft tissue sarcoma occuring in chest wall and it known to be highly recurrent. The treatment of choice is a radical wide resection including a safe margin of uninvolved structures around the grossly visible tumor. We report a case of chest wall reconstruction using Marlex sandwich and latissimus dorsi musculocutaneous flap after wide resection of desmoid tumor on the chest wall.

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3차원 전산화단층찰영 영상을 이용한 얼굴 연조직 두께 계측 (Measurement of facial soft tissues thickness using 3D computed tomographic images)

  • 정호걸;김기덕;한승호;신동원;허경석;이제범;박혁;박창서
    • Imaging Science in Dentistry
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    • 제36권1호
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    • pp.49-54
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    • 2006
  • Purpose : To evaluate accuracy and reliability of program to measure facial soft tissue thickness using 3D computed tomographic images by comparing with direct measurement. Materials and Methods : One cadaver was scanned with a Helical CT with 3 mm slice thickness and 3 mm/sec table speed. The acquired data was reconstructed with 1.5 mm reconstruction interval and the images were transferred to a personal computer. The facial soft tissue thickness were measured using a program developed newly in 3D image. For direct measurement, the cadaver was cut with a bone cutter and then a ruler was placed above the cut side. The procedure was followed by taking pictures of the facial soft tissues with a high-resolution digital camera. Then the measurements were done in the photographic images and repeated for ten times. A repeated measure analysis of variance was adopted to compare and analyze the measurements resulting from the two different methods. Comparison according to the areas was analyzed by Mann-Whitney test. Results : There were no statistically significant differences between the direct measurements and those using the 3D images (p>0.05). There were statistical differences in the measurements on 17 points but all the points except 2 points showed a mean difference of 0.5 mm or less. Conclusion : The developed software program to measure the facial soft tissue thickness using 3D images was so accurate that it allows to measure facial soft tissues thickness more easily in forensic science and anthropology.

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