• Archives of Plastic Surgery
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• v.36 no.2
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• pp.147-152
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• 2009

Purpose: First web space contracture of the hand has been treated with various surgical techniques such as Z - plasty, local flap, pedicled flap, distant free flap, and anterolateral thigh free flap. Among those surgical techniques, anterolateral thigh free flap provide a thin and pliable flap, which is a useful method for correction of first web space contracture. Methods: From August 2003 to September 2007, authors selected 9 patients who had first web space contracture with limitation of thumb abduction within 30 degrees. All of patients had received first web contracture release with anterolateral thigh free flap. Age ranged from 24 to 51, and all the patients were male. Average follow up period was 12 months and authors performed photographic analysis of the thumb abduction angle of postoperative increase. Result: All the flaps were survived. Donor site was closed with primary closure in 8 cases and covered with split - thickness skin graft in 1 case. Average flap size was $8{\times}9cm$ and average thickness was 0.6 cm in suprafascial flap. The procedure resulted in increased thumb abduction angle of $34.7^{\circ}$ in average and showed concave shape of first web space in suprafascial flap. Additional operations were performed with Z - plasty in 3 cases, local flap in 5 cases, and opponensplasty in 3 cases. Conclusion: In suprafascial flap, we obtained relatively thin flap thickness and were able to make natural concave shape of first web space. In releasing severe contracture of the first web space, anterolateral thigh free flap provided a good coverage of appropriate thickness and pliable soft tissue and allowed limited donor site morbidity.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.2
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• pp.133-139
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• 2012

This is a review regarding Mulliken's Modification using the Millard rotation-advancement principle for the repair of unilateral complete cleft lip and nasal deformity. All patients underwent prior labionasal adhesion and dentofacial orthopedics with a pin-retained (Latham) appliance used for infants with a cleft of the lip and palate. Technical variations concerning the operation are described. A high rotation and releasing incision in the columella lengthens the medial labial element and produces a symmetric prolabium with minimal transgression of the upper philtral column through the advancement flap. The orbicularis oris muscle is everted, from caudad to cephalad, to form the philtral ridge. A minor variation of unilimb Z-plasty is used to level the cleft side of Cupid's bow handle, and cutaneous closure proceeds superiorly from this junction. The dislocated alar cartilage is visualized though a nostril rim incision and suspended to the ipsilateral upper lateral cartilage. Symmetry of the alar base is addressed in three dimensions, including maneuvers to position the deviated anterior-caudal septum, configure the sill, and efface the lateral vestibular web. The authors believe the technical refinements described herein contribute favorably to the outcome of repair regarding unilateral cleft lip and nasal distortion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.5
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• pp.458-460
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• 2001

A 11-month-old infancy was referred for treatment of cleft palate. The patient's congenital deformities had included oronasal fistula on the soft palate and bifid uvula. Furrow double-opposing Z-plasty was performed under general anesthesia. However, postoperative bleeding developed at ward. Despite the pressure of operative wound, venous oozing continued and hemoglobin concentration and RBC were decreased (Hb: 5.5g/dL, RBC: $1.98{\times}10^6/mm^3$). The patient was pale and confused and transferred to Surgical Intensive Care Unit(SICU) We could not keep the peripheral venous line and there was a high risk of hypovolemic shock. Emergency transfusion was performed through the central femoral venous line and emergency operation for bleeding control was carried out. We explored the operation site and found bleeding point from the posterior pharyngeal wall. Electrocoagulation and surgicel packing were carried out and bleeding was stopped.

• Journal of Korean Foot and Ankle Society
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• v.18 no.2
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• pp.72-75
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• 2014

We experienced a patient in whom rupture of the peroneus longus tendon occurred after ostectomy of the peroneus tubercle of the calcaneus. Acute rupture of the peroneus tendon can be managed by end-to-end anastomosis, while neglected cases can be treated by tenodesis, tendon transfer, or tendon graft. In the current patient, the tendon ends were mildly retracted, yielding a small gap. We successfully repaired the retracted tendon ends after lengthening by Z-plasty.

• Archives of Plastic Surgery
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• v.33 no.3
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• pp.379-382
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• 2006

Clinodactyly is defined as an angulation of a digit in the radio-ulnar plane. This anomaly can be congenital, dominantly inherited, or acquired due to trauma or inflammation. Although the deformity usually causes little functional impairment, correction is made because of cosmetic problems. Male subject, with polydactyly on thumb(Wassel's type VII) received first surgery at the age of one. And at the age of six, abnormal growth on the radial side of the first metacarpal bone and ulnar deviation of the distal phalanx of the thumb at the interphalangeal joint had developed. The authors used the growing bony segment from the first metacarpal bone as a bone graft for the correction of clinodactyly on thumb. Z-plasty incision was made on the concave(ulnar) side of thumb and a wedge osteotomy was made on the distal phalanx. The bone graft was inserted into the gap of the distal phalanx of the thumb and fixed it with K-wires. Deformity of the metacarpal bone and clinodactyly on thumb was corrected effectively without donor site morbidity with noticible growth of the grafted metacarpal bone 12 months after surgery.

• Archives of Craniofacial Surgery
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• v.19 no.1
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• pp.48-50
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• 2018

Bony anomaly caused by lip tie is not many reported yet. There was a case of upper lip tie wrapping into the anterior premaxilla. We represent a case of severe upper lip tie of limited lip motion, upper lips curling inside, and alveolar hypoplasia. Male patient was born on June 3, 2016. He had a deep philtral sulcus, low vermilion border and deep cupid's bow of upper lip due to tension of short, stout and very tight frenulum. His upper lip motion was severely restricted in particular lip eversion. There was anterior alveolar hypoplasia with deep sulcus in anterior maxilla. Resection of frenulum cord with Z-plasty was performed at anterior premaxilla and upper lip sulcus. Frenulum was tightly attached to gingiva through gum and into hard palate. Width of frenulum cord was about 1 cm, and length was about 3 cm. He gained upper lip contour including cupid's bow and normal vermilion border after the surgery. This case is severe upper lip tie showing the premaxillary hypoplasia, abnormal lip motion and contour for child. Although there is mild limitation of feeding with upper lip tie child, early detection and treatment are needed to correct bony growth.

• The Journal of the Korean dental association
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• v.11 no.2
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• pp.117-121
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• 1973

The authors had treated 45 cases of cleft lip and cleft palate patients including 30 male patients and 15 female patients. There were 41 cases of unilateral cleft lip patients and 4 cases of bilateral cleft lip patients, and 4 cases with together cleft lips and cleft palates among the total 45 cases were showed. We had accomplished that surgical plastic closures of cleft lips and cleft palates had been performed by using of Millara's, Hagedorn's, Meyer's, LeMesurier's and Veau's methods with Z-plasty.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.1
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• pp.13-15
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• 2014

Epithelial cysts are benign epithelium-lined lesions that contain fluid or semisolid material. Most epithelial cysts in the oral cavity occur in the anterior part of the mouth floor. Cysts arising on the uvula in a cleft palate patient are rare. Intraoral examination in a 14-month-old boy with a complete cleft lip and palate revealed a cystic lesion on the right uvula. The lesion was excised and push-back palatorrhaphy with Z-plasty on the uvula was performed. Histopathological examination diagnosed an epithelial cyst. We report a case of an epithelial cyst of uvula in a patient with a unilateral complete cleft lip and palate.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.178-183
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• 2013

Cleft lip arises from congenital underdevelopment with various degrees and patterns. Mulliken named a unilateral incomplete cleft lip with no severe cleft as a lesser-form cleft lip and categorized it into three subgroups. Anatomically categorized subgroups are minor-form, microform, and mini-microform cleft by the extent of vermilion-cutaneous dysjuntion. The vermillion cutaneous notch is more than 3 mm from the regular Cupid's bow peak for minor-form, less than 3 mm for microform, and almost no gap with discontinuity on the vermillion cutaneous border for mini-microform. The treatments are rotational advancement flap for minor-form, double unillimb Z-plasty for microform, and vertical lenticular excision for mini-microform, respectively. This article aims to present the literature review about the incomplete lesser form cleft lip classified by Mulliken and to report our experiences.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.83-86
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• 2010

Purpose: Authors present the case of 2 patients who underwent extended Latissimus dorsi myocutaneous flap to reconstruct postburn breast deformity. Methods: A 39-year-old woman and 18-year-old woman with postburn breast deformity visited for reconstruction. The nipples were preserved but normal breast development did not occur due to scar contracture. Burn scar contracture was released by excision of the restricting burn scar and breast mound was reconstructed with extended Latissimus dorsi myocutaneous flap. Additional contracture release with multiple z-plasty was performed at the axillae and medial portion of breast. Results: Postburn breast reconstruction using Latissimus dorsi myocutaneous flap showed natural shaped breast mound and inframammary fold. There was no significant complication in both cases. Conclusion: Latissimus dorsi myocutaneous flap provide sufficient skin and soft tissue and it could be an effective method for reconstruction of postburn breast deformity.