• 대한정형외과 초음파학회지
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• 제4권2호
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• pp.84-87
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• 2011

볼크만 구축 환자의 술 전 준비 단계에서 척골 및 요골 동맥에 대한 도플러 초음파 유도 알렌 검사를 시행하여 청각 도플러와 CT-혈관조영술에서는 확인되지 않았던 척골 동맥의 혈류 감소를 인지할 수 있었다. 저자들은 척골 및 요골 동맥에 대한 도플러 초음파 유도 알렌 검사의 유용성에 대한 인식을 높이고자, 그 증례를 문헌고찰과 함께 보고하고자 한다.

• Archives of Reconstructive Microsurgery
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• 제9권2호
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• pp.103-109
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• 2000

Purpose : We performed this study in order to analyze the clinical results of functioning gracilis musculocutaneous free flap transplantation for reconstructon of hand function in cases of Volkmann's ischemic contracture and massive soft tissue injury of forearm. Materials and methods : 18 cases were reviewed with 5 yeas of mean follow up period. We evaluated total active motion of the finger joints and wrist, pinch and grip strength. Results : The flap were survived in 17 cases and 1 case was failed due to infection. The sum of active motion of finger joints(TAM) was improved from 0 to $173.8^{\circ}$. The average grip and pinch strength was improved from 0 kg to $2.7{\pm}2.1kg$ and from 0 kg to $2.4{\pm}1.6kg$. Conclusion : The results in most cases were acceptable in relatively long term follow-up. It may be an option for reconstruction of hand function in cases of Volkmann's ischemic contracture and traumatic upper extremity injury.

• Archives of Reconstructive Microsurgery
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• 제1권1호
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• pp.9-16
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• 1992

Volkmann's ischemic contracture is the end result of an untreated, delayed or Inadequately decompressed compartment syndrome in which muscle ischemia and necrosis have occurred. Once the muscle necrosis have happened, the involved muscle undergo permanent change into fibrous tissue. So secondary shortening and distal joint contracture will be a final outcome, which results in marked functional impairment of hand and forearm. Even though several procedures, such as muscle sliding operation has been attempted, overall results were far from satisfaction, compare to healthy opposite hand. The management of these unfavorable condition of the forearm and hand was regarded as one of challenging area in orthopedics. Recently new approach, using microsurgical technique which transfers functioning muscle unit, has been developed and its result was much better than any other methods in the aspect of an active motion. Among these musculocutaneous free flaps, gracilis has obtained special reputation due to its easiness to handle such as elevation of flap and reliable neurovascular pedicle. Other advantages are flexibility of flap size to adjust variable size of the defect in the forearm and minor morbidity of the donor site. Authors have performed 7 cases of functioning gracilis musulocutaneous free flap transplantation for the functional loss of forearm and hand due to Volkmann's ischemic contracture or muscle and skin defect due to severe trauma since November, 1981 till May, 1991. The results in most cases were satisfactory and acceptable.