• Title/Summary/Keyword: Toe loss

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Lateral Arm Free Flap for Small Sized Diabetic Foot Ulcer around Toes (족지 주위의 작은 크기의 당뇨 족부 궤양에 대한 외측 상완 유리 피판술)

  • Jung, Heun-Guyn;So, Gwang-Young;Kuk, Woo-Jong;Kim, Hee-Dong
    • Archives of Reconstructive Microsurgery
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    • v.17 no.1
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    • pp.28-35
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    • 2008
  • The purpose of this study was to present the clinical analysis of the results of lateral arm free flap for small sized and infected diabetic foot ulcer around toes. From May 2006 to December 2007, Seven patients were included in our study. Average age was 52.8 years, six were males and one was female. All had infected diabetic foot ulcer and had exposures of bone or tendon structures. Ulcers were located around great toe in four patients, 4th toe in one and 5th toe in two. Three patients had osteomyelitis of metatarsal or phalanx. After appropriate control of infection by serial wound debridement and intravenous antibiotics, lateral arm flap was applied to cover remained soft tissue defects. Posterior radial collateral artery of lateral arm flap was reanastomosed to dorsalis pedis artery of recipient foot by end to side technique in all cases in order to preserve already compromised artery of diabetic foot. All flaps were designed over lateral epicondyle to get longer pedicle and averaged pedicle length was 8 cm. Two cases were used as a sensate flap to achieve protective sensation of foot. All flaps survived and provided satisfactory coverage of soft tissue defects on diabetc foot ulcers. All patients could achieve full weight-bearing ambulation. No patients has had recurrence of infection, ulceration and further toe amputations. There were three complications, a delayed wound healing of flap with surrounding tissue, a partial peripheral loss of flap and a numbness of forearm below donor site. All patients were satisfied with their clinical results, especially preserving their toes and could return to the previous activity levels. Lateral arm free flap could be recommend for infected diabetic foot ulcers around toes, to preserve toes, coverage of soft tissue defect and control of infection with low donor site morbidity.

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Toe entrapment and injury by plastic color rings in a Pale Thrush (Turdus pallidus) and a Light-vented Bulbul (Pycnonotus sinensis) (플라스틱 유색가락지에 의한 흰배지빠귀(Turdus pallidus)와 검은이마직박구리(Pycnonotus sinensis)의 발가락 끼임과 부상)

  • Choi, Chang-Yong;Park, Chang-uk;Nam, Hyun-Young;Park, Se-Young;Bing, Gi-Chang;Cho, Sook-Young;Park, Jong-Gil
    • Korean Journal of Ornithology
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    • v.25 no.2
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    • pp.82-86
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    • 2018
  • Color rings have been commonly and widely used in many ecological and ornithological studies in the field, but color ring-induced injury in passerines is poorly documented. In this report, we describe the first case of toe loss caused by a dislocated split Darvic ring in a Pale Thrush (Turdus pallidus) that was recaptured 596 days after its initial capture and release on Hong-do Island, the Republic of Korea. We also found that a left hind toe of a Light-vented Bulbul (Pycnonotus sinensis) was entrapped by a split color ring when the bird was observed 135 days after the marking at Heuksan-do Island. Based on these two cases out of the 1,900 color ringed birds, we emphasize a precautionary approach following general guidelines in the application and use of color leg rings for future studies.

Observation of Gait Analysis of the Stroke Patient (뇌졸중환자의 보행 관찰분석)

  • Bae, Sung-soo;Kim, Sik-hyun;Kim, Sang-soo
    • PNF and Movement
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    • v.6 no.1
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    • pp.21-25
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    • 2008
  • Purpose : The purpose of this study was conducted to find out observation at gait analysis of the stroke patient with proprioceptive neuromuscular facilitation(PNF) concept. Methods : This is a literature study with books, seminar note and international PNF course book. Results : Stroke patient gait was poor initial contact by weakness of tibialis anterior or weakness of contralateral plantar flexor, poor loading response by loss of deep sensation, poor mid stance by loss of deep sensation, weakness of tibialis anterior and weakness of plantar flexors eccentric control, poor terminal stance, pre-swing, initial swing by loss of deep sensation and stiffness fo deep toe flexors. Conclusion : Stroke patient gait determine on loss of mobility, pain, fear, trunk muscle weakness, loss of coordination, loss of deep sensation, neglect and apraxia. Therefore observational gait analysis of the stroke patient focus on gait cycle and take out hypotheses from the gait cycle. These hypotheses have to define accept or not by parameters. Treatment plan made with the hypotheses.

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Integrated Packet Scheduling for VoIP Service (VoIP 서비스를 위한 통합 패킷 스케줄링)

  • Lee, Eun-Joung;Park, Hyung-Kun
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.57 no.11
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    • pp.2124-2126
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    • 2008
  • In the wireless communication systems, the demand of multimedia services is also increased. Unlike typical data packets, realtime service such as VoIP packets have delay bound and low loss rate requirement. In this paper we propose a new scheduling algorithm that be able to allocate resources to the different kinds of services such as VoIP and data packet. The proposed algorithm considers both time delay and channel condition toe determine the priority. Simulation results show that the proposed algorithm works more efficiently than the conventional algorithms.

Effects of the buried lamellar tears on the mechanical strength in the welded T joints (T형상용접 이음에서 매몰된 라멜라균열이 용접부의 기계적 강도에 미치는 영향)

  • 고진현
    • Journal of Welding and Joining
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    • v.6 no.4
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    • pp.44-53
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    • 1988
  • The mechanical strengths of buried lamellar tears located near the weld toe in the welded tee joints were evaluated in terms of the loss of load carrying capacity as a function of tear area. In static loading, the load carrying capacity was significantly reduced when tear intercepted over 10% of the cross-sectional area of the welded joints. However, the welded joints containing buried tears still failed at stresses over the yield strength of the base metal in the through-thickness direction in spite of the presence of tears up to 20-25% of the area. Fatigue strength of welded joints containing tears markedly reduced with increasing tear areas. Lehigh lamellar tearing test used in this study to produce speicmens was described in detail. The load carrying cpapacity in static loading was influenced by the reduction of supporting area whereas that in fatigue loading was influenced by the stress-concentration effects of lamellar tears and the reduction of supporting area. In bend tests, the pre-existing lamellar tears always grew up toward the weld toe. However, in fatigue loading, cracks grew up and down simultaneously form both the weld toe and the top of lamellar tears because of stress concentration. In fatigue loading, delaminations and decohesion of inclusion/matrix interface generated in multipass welds provided crack propagation paths and enhanced crack propagation because the tips of delaminations and deconhesios acted as stress raisers.

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Backward Slip as a Measure of Floor Slipperiness (미끄럼 측정치로서의 뒤로미끄러짐)

  • Myung, Rohae
    • Journal of the Ergonomics Society of Korea
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    • v.20 no.2
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    • pp.47-57
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    • 2001
  • To simulate an actual slip to measure floor slipperiness, slip resistance testers simulate slip in only forward direction because forward slip in the landing phase was found to be the most important factor for loss of balance. Backward slip in the take off phase was possible but was excluded in the friction test protocol because it was not dangerous. However, backward slip was tested in the friction test protocol without any theoretical background of the significance in generating dangerous slips and falls and was proven to be as good as forward slip in measuring floor slipperiness. Therefore, this study was designed to investigate the significance of backward slip in generating dangerous slips and falls with different combinations of floor and shoe sole. The results showed different tendency of backward slip in take off phase being significant in generating dangerous slips and falls because backward slip in the takeoff phase affected gait pattern disturbances seriously. resulted in dangerous falls. Fast toe velocity increased the severity of backward slip and confirmed the significance of backward slip in generating dangerous slips and falls. As a result, this study recommends the utilization of backward slip in the measurement of floor slipperiness.

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The Effects of Trunk Exercises on the Balancing Ability of Elderly Hansen's Disease Patients with Lower Extremity Dysfunction (체간운동이 하지기능장애 한센노인의 균형능력에 미치는 영향)

  • Jung, Soon-Mi
    • Journal of the Korean Society of Physical Medicine
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    • v.7 no.1
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    • pp.77-85
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    • 2012
  • Purpose : The purpose of this study was to investigate the effects of trunk exercises on the balancing ability of elderly Hansen's disease patients with lower extremity dysfunction. Method : A total of 24 elderly Hansen's disease patients were divided into two groups: 10 without lower extremity dysfunction and 14 with lower extremity dysfunction. The groups exercised for 60 minutes, two days a week, for a total 12 weeks; balancing ability was measured with the one leg standing test, tandem walking test, and timed up-and-go test. The patients were tested and their results were compared both before and after the completion of their exercise programs. Lower extremity dysfunction was assessed according to the following criteria: unilateral foot-drop, toe-loss, and below-knee amputation. Results : After the exercises, participants in both groups showed a positive, statistically significant difference in balance, compared with before the exercises (the one leg standing test, tandem walking test, and timed up-and-go test; p<.05). For comparison purposes, the group with dysfunction and the group without dysfunction were tested before and after the completion of their exercises. Before the exercises, there was a statistically significant difference in the one leg standing test, tandem walking test, and timed up-and-go test (p<.05). However, after the exercises, there was no significant difference in the one leg standing test, tandem walking test, and timed up-and-go test (p>.05). Conclusion : Ultimately, balancing ability was improved in both of the groups after trunk exercises were performed. Although balancing ability was improved, elements of lower extremity dysfunction remained, such as unilateral foot-drop, toe-loss, and below-knee amputation.

Morbidity of the Foot as a Free-Flap Donor Site (유리 피판 공여부로서 족부의 이병률)

  • Lee, Kwang-Suk;Wie, Dae-Gon;Han, Sang-Won
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.39-46
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    • 1997
  • The methods of clinical applications of the foot as a free-flap donor site includes microvascular toe-to-finger transfer, free neurovascular flap transfer, first web space flap transfer, and osteocutaneous free flap transfer. We have evaluated the results of treatment for 35 patients to be undergone a microvascular reconstructive procedure with the foot as a donor site from January 1982 to June 1996. The performed operations were 16 cases of thumb reconstruction with wrap around procedure, 3 cases of tenocutaneous flap transfer, 10 cases of dorsalis pedis flap transfer, 2 cases of first web space free flap and 4 cases of toe-to-finger transfer. The follow up study was 69 months in average. Regarding to the various donor sites, morbidity was divided into five different categories: Cosmesis, Functional loss, Sensory loss, Wound complication, and Pain. According to the results of examination(35 patients), the results was excellent(25), good(9), fair(1), and poor(0). Among the categories, morbidity was higher at cosmesis. The patients under 50 years were better outcome. Among the operative methods from the foot as a donor site, thumb reconstruction with wrap around procedure showed poorest outcomes. So, We conclude that the foot as a free flap donor site is a good source for the microvascular reconstructive surgery. But, Preoperative donor site evaluation, adequate operative technique and post operative management are essential to decrease the morbidity of donor site.

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Paraplegia Following Celiac Plexus Block -A case report- (복강신경총 차단후 하지마비 -증례 보고-)

  • Na, Ae-Ja;Moon, Dong-Eon;Suh, Jae-Hyun
    • The Korean Journal of Pain
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    • v.6 no.1
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    • pp.129-132
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    • 1993
  • Paraplegia complicating a block of the celiac plexus with alcohol for recurrent stomach cancer is described. A 33 year old male patient was admitted to control for severe epigastric pain. With the patient in prone position, the needle was advanced further than 2 cm on the anterior margin of $L_1$ vertebral body under fluoroscopy. 3 ml of 1% lidocaine and 5 ml of conray were injected through each needle, and the diffusion of the contrast medium was checked, This was followed by 7 ml of pure alcohol and 8 ml of 50% alcohol for each needle. At that time, the patient was very satisfied with loss of abdominal pain. About 30 minutes after injection of alcohol, suddenly patient complained of severe burning pain on back and both extremities. Thereafter, loss of sensation and paralysis in both extremities were developed slowly. The senstivity to cold recovered 3 days after block. By the 33rd day after the block, sensation had recovered in both extremities, the bladder and rectum. Movement of the right ankle joint and left great toe was also possible.

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Evaluation of Muscle Activity and Foot Pressure during Gait, and Balance Test in Patients with Genu Valgum (무릎외반의 균형 검사 및 보행 중에 근활성도와 발바닥압의 평가)

  • Yoon, Jeong-Uk;Yoo, Kyung-Tae;Lee, Ho-Seong
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.1
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    • pp.127-137
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    • 2022
  • PURPOSE: This study sought to evaluate muscle activity and foot pressure during gait, and balance in female college students with genu valgum. METHOD: Participants were assigned based on their Q-angle to genu valgum group greater than 20° (GVG, n = 12), unilateral genu valgum group greater than 20° (UVG, n = 11), and control group (CON, n = 13). All subjects were evaluated for balance (Trace length, C90 area, C90 angle, and the Romberg test), muscle activity (gluteus medius; GM, tensor fasciae latae; TFL, vastus medialis; VM, vastus lateralis; VL, biceps femoris; BF, gastrocnemius; GCM and tibialis anterior; TA) and foot pressure (F/F ratio, R/F ratio, Hallux, 2~5 toe, 1st MT, 2~4 MT, 5th MT, Midfoot, M/heel, and L/heel) during gait. RESULTS: Romberg test showed significantly increased loss of balance in the UVG group compared with the CON. In the forward position, the imbalance was significantly increased in the UVG and GVG groups compared to the CON. Muscle activity of VL, GCM, and TA significantly increased in the GVG group compared with the CON. Static foot pressure, 1st MT significantly increased in the GVG compared to the CON group. The 5th MT significantly decreased in the CON compared with the GVG group. The R/F ratio significantly decreased in the GVG compared to the CON group. In dynamic foot pressure, the 2~5 toe significantly increased in the GVG compared with the UVG group. The left 5th MT significantly decreased in the UVG compared with the CON and GVG groups. CONCLUSION: These results indicate that genu valgum has a negative effect on balance, muscle activity, and foot pressure during gait in female college students.