• Title/Summary/Keyword: Upper limb surgery

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Myositis Ossificans on the Nasal Dorsum: A Case Report (콧등에 발생한 화골성 근염: 1례 보고)

  • Song, Jennifer K.;Hwang, So-Min;Lim, Kwang-Ryeol;Jung, Yong-Hui;Ahn, Sung-Min
    • Archives of Plastic Surgery
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    • v.38 no.1
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    • pp.69-72
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    • 2011
  • Purpose: Myositis ossificans is a benign condition of heterotopic bone formation that still requires more of its pathologic explanation. The lesions are localized predominantly to the high-risk sites of injury, involving flexor muscles of the upper limbs and thigh, but rarely in the head and neck area. Methods: A case of a 44-year-old male patient presented with a palpable hard mass on nasal dorsum. The patient experienced a similar lesion on upper limb few years ago. On computed tomographic image, the lesion presented focal definite increase in opacity compatible to adjacent bone densitiy on nasal dorsum. Results: The lesion was excised under open rhinoplasty incision. The pathologic report revealed focal bone formation and calcification within skeletal muscle. Conclusion: We describe a unique and only case of a myositis ossificans on nasal dorsum which is indifferent from previous concept.

Lymphaticovenular Anastomosis: Superficial Venous Anatomical Approach

  • Winaikosol, Kengkart;Surakunprapha, Palakorn
    • Archives of Plastic Surgery
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    • v.49 no.5
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    • pp.689-695
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    • 2022
  • Background Lymphaticovenular anastomosis (LVA) is an effective, functional treatment for limb lymphedema. This study reports an alternative surgical approach to lymphedema treatment without the use of indocyanine green mapping. Methods A retrospective analysis was performed on 29 consecutive lymphedema patients who underwent LVAs from January 2015 to December 2020, whereby incisions were made along the anatomy of the superficial venous systems in both upper and lower extremities around the joint areas. The evaluation included qualitative assessments and quantitative volumetric analyses. Result The mean number of anastomoses was 3.07, and the operative time was 159.55 minutes. Symptom improvement was recorded in 86.21% of the patients, with a mean volume reduction of 32.39%. The lymphangitis episodes decreased from 55.17% before surgery to 13.79% after surgery, and the median number of lymphangitis episodes per year decreased from 1 before surgery to 0 after surgery. Conclusions The superficial venous anatomical approach is an easy way to start a lymphedema practice using LVA without other advanced surgical equipment. With this reliable technique, microsurgeons can perform LVA procedures and achieve good results.

Forearm Replantation for a Patient Presented with Major Amputation Injury: A Case Report

  • Jang, Jihoon;Lim, Kyoung Hoon;Kim, Joon-Woo;Kim, Hyung-Kee
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.187-190
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    • 2016
  • With the development of safety measures for employees who work with dangerous machinery, the frequency of amputation injuries has been decreasing with resultant decrease in replantation procedures. However, in some patients with major amputation injury, replantation is still necessary for the preservation of limb and it's function. The replantation of the upper extremity (UE) is a complex and technically demanding surgical procedure. For the successful replantation of UE, the type of injury, reconstruction sequence, ischemic time, and other combined injury of patient should be considered. We report a case of major amputation of UE by guillotine-type injury and discuss the treatment process of this patient.

Effects of Manual Lymphatic Drainage and High Frequency Diathermy on Pain, Volume, Function of Upper Extremity and Quality of Life in Breast Cancer Patients with Axillary Web Syndrome : a Study of Five Case Reports (겨드랑이막증후군을 가진 유방암 환자들의 도수림프배출법과 고주파 투열치료가 통증, 부피, 기능 및 삶의 질에 미치는 효과 : 사례군 연구)

  • Ahn, Soo-Yeon;Shin, Won-Seob
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.4
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    • pp.19-28
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    • 2021
  • Purpose : The purpose of this study was to apply manual lymphatic drainage (MLD) and high-frequency diathermy (HFD) to patients with axillary web syndrome (AWS), one of the side effects of breast cancer surgery, and to treat upper extremity pain, volume, function of the upper extremity, (joint range of motion; ROM, disabilities of the arm, shoulder and hand; DASH) and quality of life before and after treatment. It is to determine the effect of treatment by checking the level change. Methods : This study is a case series. A total of 5 patients diagnosed with AWS after breast cancer surgery voluntarily participated in this study. The intervention program consisted of stretching, MLD and HFD. It was conducted 3 times a week for 30 minutes for 4 weeks. In order to compare the effects of pain (numeric pain rating scale; NPRS), volume, upper limb function (ROM, DASH) and quality of life (the European organization for research and treatment of cancer quality of life questionnaire-breast, EORTC QLQ-BR23) evaluations were compared before and after 4 weeks of intervention. All measured variables were analyzed and expressed as mean, standard deviation and percentage. Results : The shoulder NPRS level of the subjects in all case groups decreased, the volume decreased and the shoulder flexion, abduction ROM increased. It showed improvement in DASH and quality of life, QLQ-BR23. Conclusion : After breast cancer surgery, we confirmed the possibility that MLD and HFD treatments could be effective in improving pain, decreasing volume, increasing upper extremity function, and quality of life for patients who have difficulties with AWS. The possibility has been confirmed, and additional research is needed by increasing the number of participants in the experiment in the future.

A study on the change of limb muscle atrophy by the period of limited activities following the heart surgery in congenital heart disease children (선천성 심장질환아의 수술후 활동제한 기간에 따른 사지근 위축 변화에 관한 연구)

  • Choe Myoung Ae
    • Child Health Nursing Research
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    • v.4 no.1
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    • pp.17-30
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    • 1998
  • In order to investigate the effects of a decreased activity on skinfold thickness, circumference and muscle strength of the extremities during the recovery period following heart surgery, skinfold thickness, circumference and muscle strength of the extremities were measured on days 0, 3, 6, and 9 following the surgery, and compared with those on the arrival day of intensive care unit. Skinfold thickness was measured using a skinfold caliper(Saehan Cor., Korea), circumference of the limbs were measured with a tape measure, upper extremity strength was determined using the Takei grip dynamometer and lower extremity strength was measured by pressing the flatfoot on an electronic digital health meter while tying on a bed. Results from this study were thus : 1. Skinfold thickness of triceps, quadriceps and gastrocnemius muscle on days 3, 6, 9 following the heart surgery was not significantly different from that of on the day of operation. 2. Circumference of midupperarm and midthigh on days 3, 6, 9 following the heart surgery was not significantly different from that of on the day of operation. Circumference of midcalf on days 3, 6 following the heart surgery was not significantly different from that of on the day of operation, while that of midcalf on day 9 following the surgery decreased significantly compared with that of on the day of operation. 3. Muscle strength of the upper extremity was not significantly different from that of on the day of operation, while that of the lower extremity on day 9 following the surgery decreased significantly compared with that of on the day of operation. From these results, it may be concluded that circumference and muscle strength of lower extremity can be decreased due to the postoperative inactivity following heart surgery in congenital heart disease children.

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Incomplete cleft palate related to Cornelia de Lange syndrome -A case report- (Cornelia de Lange syndrom 환아에서 발생한 Incomplete cleft palate의 치험례)

  • Yoon, Bo-Keun;Lee, Hwan-Soo;Shin, Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
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    • v.3 no.1
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    • pp.33-36
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    • 2000
  • Cornelia de Lange syndrome is a disorder of unknown biochemical and geneic basis that is recognized on the basis of characteristic facies(low anterior hairline, synophrys, anteverted nares, maxillary prognathism, long philtrum, carp mouth) in association with prenatal and postnatal growth retardation, mental retardation and, in many cases, upper limb anomalies. We treated the patient with incomplete cleft palate related to Cornelia de Lange syndrome.

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Role of the Surgical Glove in Modified Vacuum-Assisted Wound Healing

  • Hemmanur, Shankar Ram;Siddha, Loka Vijayan
    • Archives of Plastic Surgery
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    • v.40 no.5
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    • pp.630-632
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    • 2013
  • Vacuum-assisted wound healing has been proven to be more efficacious than conventional dressings. Vacuum dressing has been frequently modified given the restrictions in resources available. Here we present a modified method of vacuum dressing by using surgical or gynaecological gloves for lower and upper limb wounds. Vacuum dressing was applied with parts of a surgical or gynaecological glove and Opsite with T-tailing of the suction outlet. Vacuum-assisted wound healing using the surgical gloves showed relatively good wound healing in the amputation stump, finger, arm, and leg in the cases studied.

Guillain-Barré Syndrome after Lung Transplantation in the Immediate Postoperative Period: Case Report

  • Gu, Byung Mo;Ko, Ho Hyun;Lee, Hong Kyu;Ra, Yong Joon;Lee, Hee Sung;Kim, Hyoung Soo
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.396-399
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    • 2021
  • A 58-year-old man, incapable of maintaining oxygen saturation with mechanical ventilation, was admitted to our hospital for veno-venous extracorporeal membrane oxygenation (ECMO) treatment. He was diagnosed with acute respiratory distress syndrome (ARDS) due to influenza A pneumonia. His condition stabilized with antibiotics and steroid administration, but weaning from ECMO failed due to post-infectious pulmonary sequelae. On day 84 after admission, he underwent bilateral lung transplantation. In the postoperative phase, he did not regain consciousness even after discontinuation of sedatives for 3 days. However, spontaneous pupillary reflex and eye movements were preserved, while communication and upper and lower limb movements were affected. The nerve conduction study was diagnostic of Guillain-Barré syndrome. He was managed with intravenous immunoglobulins and plasmapheresis. Mild recovery of the facial muscles was seen, but he died 24 days post-surgery due to progressive ARDS and sepsis.

Pilomatricoma of the Subauricular Region: Report of Case (하이개부에 발생한 모기질종)

  • Yoo, Dae-Hyun;Choi, Moon-Ki;Oh, Seung-Hwan;Kwon, Dae-Keun;Jun, In-Chul;Son, Do-Kyoung;Park, Sung-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.6
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    • pp.582-587
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    • 2010
  • Pilomatricoma or calcifying epithelioma is a benign tumor of hair follicle origin. Pilomatricoma presents a slowly enlarged and asymptomatic mass that located dermal or subdermal area. It showed mostly on face and upper limb and head and neck represents 50% of all case. And it developed almostly in the first 2 decade of life. Histologically, encapsulated mass composed of solid small basophilic cells and eosinophilic ghost cells. Surgical excision is the treatment choice and rarely recurs. The purpose of this article is to represent of pilomatricoma on subauricular region that treated with mass excision and local transpositional flap. Althrough the presurgical diagnosis of pilomatricoma may be difficult, clinicians must keep in mind the differential of head and neck masses that located subdermal layers.

Unplanned Excision of Soft Tissue Sarcoma: Patient Profile and Treatment Outcomes (연부 조직 육종에 대한 무계획적 절제술: 환자의 임상적 특징 및 치료 결과)

  • Lee, Jae Hoo;Cho, Yong Jin;Kim, Seung Hyun;Shin, Kyoo Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.2
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    • pp.72-77
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    • 2012
  • Purpose: Unplanned excision of a soft tissue sarcoma is defined as the operation performed for gross removal of a soft tissue sarcoma without regard for preoperative imaging or the necessity to removal a margin of normal tissue covering the cancer. We report our experience of treating primary soft tissue sarcoma after an unplanned excision. Materials and Methods: We retrospectively reviewed 31 patients referred to our hospital after unplanned excision at other hospitals for treatment of a STS. The clinical information was reviewed with a focus on the patient's age, gender, tumor location, tumor size, tumor depth, presumptive diagnoses at the previous surgery, refer hospital, definitive diagnosis, interval between the initial and additional surgery and local recurrence. Results: There were 19 males and 12 females with a median age of 48 years (range, 17-75 years) at the time of referral. Seventeen patients (54.8%) had tumors in their lower limb, 6 (19.4%) had tumors in their upper limb, and 8 (25.8%) had tumors in their trunk. Tumor depth could be determined for 8 patients (25.8%), with superficial and 22 deep tumors (71%). The medial interval between unplanned excision to re-excision ranged from 2 weeks to 1 year (median, 5 weeks). Local recurrence was detected in 2 patients. All patients were alive without metastasis at last follow up. Conclusion: Even in upper class general hospital, many unplanned excision had been performed, which is considered to be avoided. When the relatively huge mass located in deeper layer it requires enough preoperative imaging studies and biopsy.