• Title/Summary/Keyword: Tendon graft

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Surgical Treatment of Sternoclavicular Joint Dislocation Using a T-plate

  • Hwang, Wan Jin;Lee, Yeiwon;Yoon, Yoo Sang;Kim, Young Jin;Ryu, Han Young
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.221-223
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    • 2016
  • A 22-year-old man was hospitalized with a sternoclavicular joint (SCJ) dislocation caused by a traffic accident. Surgical reduction and fixation of the SCJ were performed using a T-plate. SCJ dislocation is rare, accounting for less than 1% of all dislocations, and is usually treated conservatively, although severe cases may require surgery. Surgery typically involves joint reduction and fixation using an autologous tendon graft, but this has disadvantages such as the requirement for additional surgery to obtain autologous tissue and an extended operative time. To overcome these issues, here, we performed a simple SCJ reduction and fixation using a T-plate and achieved good results.

A review of chronic pectoralis major tears: what options are available?

  • Joshua R. Giordano;Brandon Klein;Benjamin Hershfeld;Joshua Gruber;Robert Trasolini;Randy M. Cohn
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.330-339
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    • 2023
  • Rupture of the pectoralis major muscle typically occurs in the young, active male. Acute management of these injuries is recommended; however, what if the patient presents with a chronic tear of the pectoralis major? Physical exams and magnetic resonance imaging can help identify the injury and guide the physician with a plan for management. Nonoperative management is feasible, but is recommended for elderly, low-demand patients whose functional goals are minimal. Repair of chronic tears should be reserved for younger, healthier patients with high functional demands. Although operative management provides better functional outcomes, operative treatment of chronic pectoralis tears can be challenging. Tendon retraction, poor tendinous substance and quality of tissue, muscle atrophy, scar formation, and altered anatomy make direct repairs complicated, often necessitating auto- or allograft use. We review the various graft options and fixation methods that can be used when treating patients with chronic pectoralis major tears.

Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft - The comparison of mid term & long term follow-up results - (골-슬개 건-골을 이용한 전방 십자 인대 재건술 - 중기 및 장기 추시 결과의 비교 -)

  • Song Eun Kyoo;Yoon Taek Rim;Lee Young Keun;Kim Jong Seok
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.117-122
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    • 2000
  • Purpose : To compare the mid term with long term follow up results of the anterior cruciate ligament(ACL)> reconstruction using patellar tendon. Materials and Methods : Seventy-six cases, which could be followed up more than 2 years were included in this study. They were classified into two groups, mid-term group(41 cases) with mean follow-up periods of 2 years and 10 months and long-term group(35 cases) off years and 6 months. Clinical and radiological results and peripatellar complications were evaluated & compared. Results . There was no statistically significant difference in radiological finding and anterior instability between two groups. However, the incidence of anterior knee pain, paresthesia at incision site, kneeling pain, crepitus and quadriceps weakness was lower in long-term group than in mid-term group. Conclusion : ACL reconstruction using patellar tendon graft could successfully restone the stability of knee joint, but there are some complications in donor site and patellofemoral joint. However this complications were gradually decreased with long term follow-up.

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Comparison of the Results of One-Incision Technique Versus Two-Incision Technique of the Arthroscopic Posterior Cruciate Ligament Reconstruction using Bone-Patellar Tendon-Bone Graft (일절개법을 이용한 관절경적 후 십자 인대 복원술 - 이절개법과의 비교 -)

  • Kim, Sung-Jae;Kim, Hyun-Kon;Kim, Hyon-Jeong;Kim, Han-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.33-39
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    • 1998
  • This study was done to compare the results of the one-incision technique and the conventional two incision technique for the arthroscopic treatment of the posterior cruciate ligament injury. Fifty-five patients with the posterior cruciate ligament injury underwent the arthroscopic posterior cruciate ligament reconstruction using bone-patellar tendon-bone(BTB) graft. Patients with combined ligament injuries requiring concomitant operative treatment were excluded in this study. The conventional two-incision technique was performed in ten patients(Group I) and the one-incision technique in forty-five patients(Group II). The average duration of follow-up was 45 months in Group I(range, 40 to 50 months) and 36 months in Group II(range, 24 to 68 months). Auto BTB grafts were utilized for all patients in Group I. In Group II, 34 BTB autografts and 11 BTB allografts were utilized. The functional results were evaluated according to the Lysholm Knee Scoring scale and the Hospital for Special Surgery(HSS) knee ligament rating form. The postoperative posterior laxity was measured with a KT 1000 or 2000 arthrometer. Lysholm postoperative mean values were 90.0 in Group I and 90.6 in Group II. HSS mean values were 87.7 in Group I and 92.6 in Group II. HSS postoperative mean value showed better results in Group II(p=0.037). The average side-to-side difference of the posterior translation measured by the KT 2000 arthrometer were 2.10 mm(range, 1 to 4 mm) in Group I and 2.38 mm(range, 0 to 5 mm) in Group II. But there was no statistically significant difference. In Group II, the results of the autograft and allograft showed no significant difference. The arthroscopic posterior cruciate ligament reconstruction using one-incision technique showed good results comparable to the conventional two-incision technique. This technique minimizes potential injury to the extensor mechanism, especially vastus medialis obliquus, and scar formation over the medial femoral condyle. The operation can be finished within one tourniquet time by using only one-incision.

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Tendocutaneous Free Flap Transfer from Dorsum of the Foot (족배부 유리편을 이용한 생건 피부편이식)

  • Lee, Kwang-Suk;Park, Sang-Won;Byun, Young-Soo;Kang, Ki-Hoon;Kang, Oh-Yong
    • Archives of Reconstructive Microsurgery
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    • v.1 no.1
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    • pp.24-30
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    • 1992
  • Tendocutaneous free flap transfer has been usually used to treat troublesome wounds, which had extensive defect of skin and tendons, since Daniel and Taylor had reported successful free flap transfer in 1973. Among the numerous types of free flap, the dorsalis pedis flap, which could include superficial peroneal nerve, extensor tendon and second metatarsus, was widely used as composite free flap. The authors analysed 13 cases of tendocutaneous free flap transfer from dorsum of the foot which were operated at Korea University Hospital from March 1981 to August 1991. The results were as follows: 1. The average size of these flaps was $53.7cm^2$(mazimum $82cm^2$, minimum $30cm^2)$, the average number and length of tendons were 2.9(maximum, 5, minimum 1), and 9.2cm (maximum 17cm, minimum 5cm). 2. The survival rate of flaps was 100%, and functional results by Dargan's criteria were 4 in excellent, 4 good, 3 fair and 2 poor. 3. The delayed healing on donor site could prevented by the meticulous skin graft and repair of extensor retinaculum. 4. The cases of electrical burn were more worse than the traumatic cases in functional results.

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Two Cases of Radial Forearm Free Flap Reconstruction after Wide Vertical Hemipahryngolaryngectomy (진행된 이상와암의 광범위 수직인후두부분절제술 후 요전완 유리피판을 이용한 재건술 2예)

  • Moon Il-Joon;Hong Sung-Lyung;Kim Si-Whan;Ahn Soon-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.1
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    • pp.35-41
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    • 2005
  • Wide vertical hemilaryngopharyngectomy with immediate glottic and pharyngeal reconstruction using a radial forearm free flap is reported in 1991 by Chantrain et al. This procedure was designed for the preservation of healthy hemilarynx and resection of pharynx with safe oncological margin in especially piriform sinus cancer or supraglottic cancer invading the hypopharynx. In the original paper, they used palmaris longus tendon for reconstruction of neoglottis. In other groups, they used rib cartilage instead of palmaris longus tendon. In this paper, we report two cases of piriform sinus cancer patients who treated with wide vertical hemilaryngectomy with radial forearm free flap reconstruction. In one case, the operation was performed as Chantrain et al described. But in another case, the ipsilateral forearm was impossible due to the positive Allen's test. So the contralateral forearm flap and rib cartilage graft was done. This reconstructive technique make large resection possible. As the dissection of thyroid cartilage and lateral displacement makes direct visualization and manipulation of piriform sinus lesions, sufficient resection margin in lateral and inferior pharyngeal wall cab be obtained.

The Result of the Arthroscopic Reconstruction of Posterior Cruciate Ligament with Autogenous or Allogenous Graft (자가 또는 동종 이식물을 이용한 후방 십자 인대 재건술 후의 결과)

  • Chon Je-Gyun;Kim Eui-Soon;Choi Bo-Yeul;Yoon Chang-Hoon;Lee Jeong-Woung;Sun Doo-Hoon;Moon Myung-Sang
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.74-79
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    • 2001
  • Purpose : The purpose of this study is to evaluate the clinical results after arthroscopic PCL reconstruction and to compare the clinical results after arthroscopic PCL reconstruction using BPTB(bone patellar tendon bone) autograft(Group I : 11 cases), Achilles tendon allograft(Group II : 7 cases) and BPTB allograft(Group 111.6 cases). Materials and Methods : We reviewed the result of 24 patients who had been managed with arthroscopic reconstruction using different graft materials such as BPTB autograft, Achilles tendon allograft and BPTB allograft. Twenty-four patients(average age, 37 years) with PCL rupture were retrospectively evaluated more than one year(average, 31 months) after having arthroscopic posterior cruciate ligament reconstruction. The clinical results were evaluated by IKDC ligament standard evaluation form, using $KT-2000^{TM}$ knee ligament arthrometer and also evaluated Lysholm knee scoring scale. Results : The final evaluation was nearly normal in 11 patients($45\%$ in Group I, $43\%$ in Group II, $50\%$ in Group III). The corrected posterior sagging was abnormal(side to side difference more than 6mm) in 8 patients($36\%$ in Group I, $29\%$ in Group II, $33\%$ in Group III). We could not find significant difference among three groups by IKDC scale. Conclusion : Comparing with other reports, our overall results were not satisfactory. And also, we could not find any remarkable difference among the three groups. Further research is necessary to evaluate new surgical approaches as well as improved techniques for capsular and collateral ligament injuries.

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Clinical Evaluation of Pediatric Hand Injury (소아의 수부손상에 대한 임상적 고찰)

  • Kim, Jeong-Jin;Kim, Jeong-Cheol;Suh, Dong-Bo;Choi, See-Ho;Seul, Jung-Hyun
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.202-208
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    • 1991
  • Hand injury in children was increased due to multiple environmental risks and failed attention of parents to children in rapidly developing society. By the results of this evaluation in 37 cases, it was summarized as follows. First, hand injuries in children most commonly occurs in spring, and occurs more commonly in the children at the age of high activity. The most common level of injury is zone I by microreplantation zone, and zone II by tendon injury zone. The more desirable results were obtained by full thickness skin graft and composite graft if it were possible. For the better functional results compare to adults, the methods and procedures must be constructed after more evaluation with more clinical cases. In the cases of pediatric hand injury, the most important fact is prevention of injury, with the close attention by parents, and the second is appropriate diganosis and treatment for more functional results.

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Hand & Foot Dorsum Reconstruction in Children using Parascapular Free Flap (부견갑부 유리 피판을 이용한 소아의 손, 발등 재건)

  • Kim, Sukhan;Hyon, Wonsok;Lee, Jihyuck;Mun, Goohyun;Bang, Saik;Oh, Kapsung
    • Archives of Reconstructive Microsurgery
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    • v.13 no.1
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    • pp.63-67
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    • 2004
  • Because traumatic tissue damage on hands and feet often lead to loss of function, permanent deformity, prompt and adequate reconstruction is essential. For children, future growth, as well as function and esthetics, must be taken into account. Several techniques have been employed to reconstruct hand and foot dorsum defects of children. However, skin graft and muscle free flap with skin graft cannot prevent contracture and will interfere with normal growth. Fasciocutaneous free flap reduces contracture and enables early physical therapy, decreasing the need for additional surgical intervention. Parascapular flap is particularly suitable because it has reliable pedicle and is relatively thin. There is little functional loss in the donor site, and also simultaneous extensor tendon reconstruction of hand and foot is possible. The disadvantage of this technique is that postoperative defatting is needed to adjust volume. Our department has achieved satisfactory results using this approach, and would like to report 13 cases of hand and foot reconstruction using parascapular flap in patients under the age of 15 (from March, 1998 to May, 2003).

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The Clinical Outcome of Flap Coverage for the Treatment of Malignant Melanoma (악성 흑색종 치료를 위한 피판술의 임상적 결과)

  • Jeon, Woo-Joo;Kang, Jong-Woo;Kim, Il-Hwan;Son, Gil-Soo;Park, Jong-Woong
    • Archives of Reconstructive Microsurgery
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    • v.19 no.2
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    • pp.81-87
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    • 2010
  • In surgical treatment of the malignant melanoma, radical resection and a sentinel lymph node biopsy are essential procedures to eradicate the tumor and to minimize the risk of local recurrence. For the reconstruction of skin defect after tumor resection, a skin graft has been generally performed procedure. However, if tendon or bone is exposed after tumor resection, simple skin graft is not enough for the coverage of the defect and additional procedure is mandatory. In this study, we reviewed the clinical results of 16 patients, who had been diagnosed with malignant melanoma of the limb and underwent surgical resection and reconstruction of the defect with various methods. The sentinel lymph node dissection was performed in all patients combined with radical excision of the tumor. In 11 cases of positive sentinel lymph nodes, further elective lymph node dissections were performed. The mean tumor invasion depth was 4.54 mm (2~10 mm), and AJCC stage II was most common (9 cases). The pedicled flaps were performed in 10 cases for the reconstruction of defects. All flaps were successfully survived without significant complications until the last follow up. In conclusion, a pedicled flap coverage is very useful reconstruction strategy for the soft tissue defects after radical resection of malignant melanoma.

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