• Title/Summary/Keyword: femoral lengthening

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Complications of Femoral Lengthening Using Monolateral External Fixator in Rabbits (토끼에서 단측성 외고정기구를 이용한 대퇴골 신연술의 합병증)

  • Song, Hae-Ryong;Hwang, Jae-Min;Koo, Ja-Min;Kim, Hyeon-Hui;Lee, Won-Ik;Kim, Gon-Sup;Lee, Hyo-Jong;Chang, Ki-Churl;Yeon, Seong-Chan
    • Korean Journal of Veterinary Research
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    • v.42 no.3
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    • pp.411-418
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    • 2002
  • Thirty rabbits underwent femoral lengthening using monolateral external fixator to evaluate results and complications of limb lengthening. Twenty rabbits survived until consolidation of callus formed at the lengthening site after finishing lengthening. Ten rabbits were sacrificed during femoral lengthening because of complications. Survived 20 rabbits were classified to two groups according the amount of lengthening: group I (10% lengthening of the femoral length); group II (20% lengthening). There was no significant difference of consolidation time between two groups (p=0.25). Varus angulation at the lengthening site occurred in 60% of two groups and the amount of varus angulation in group II was larger than that of group I. Degenerative change of articular cartilage at the medial condyle of the distal femur was found in 30% of group II. Of sacrificed ten rabbits, 5 had pin loosenings with pull an of pins from the femur, 2 had fermoral fractures around the pin-tract site, and 3 had severe osteomyelitis of the femur around the pin-tract site.

The Use of Arteriovenous Bundle Interposition Grafts in Microsurgical Reconstruction: A Systematic Review of the Literature

  • Kareh, Aurora M.;Tadisina, Kashyap Komarraju;Chun, Magnus;Kaswan, Sumesh;Xu, Kyle Y.
    • Archives of Plastic Surgery
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    • v.49 no.4
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    • pp.543-548
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    • 2022
  • Microvascular reconstruction frequently requires anastomosis outside of the zone of injury for successful reconstruction. Multiple options exist for pedicle lengthening including vein grafts, arteriovenous loops, and arteriovenous bundle interposition grafts. The authors performed a systematic review of arteriovenous bundle interposition grafts to elucidate indications and outcomes of arteriovenous grafts in microvascular reconstruction. A systematic review of the literature was performed using targeted keywords. Data extraction was performed by two independent authors, and descriptive statistics were used to analyze pooled data. Forty-four patients underwent pedicle lengthening with an arteriovenous graft from the descending branch of the lateral circumflex femoral artery. Most common indications for flap reconstruction were malignancy (n = 12), trauma (n = 7), and diabetic ulceration (n = 4). The most commonly used free flap was the anterolateral thigh flap (n = 18). There were five complications, with one resulting in flap loss. Arteriovenous bundle interposition grafts are a viable option for pedicle lengthening when free flap distant anastomosis is required. The descending branch of the lateral circumflex femoral artery may be used for a variety of defects and can be used in conjunction with fasciocutaneous, osteocutaneous, muscle, and chimeric free flaps.

Application of Supercharge End-to-Side (SETS) Obturator to Femoral Nerve Transfer in Electrical Injury-Induced Neuropathy to Improve Knee Extension

  • Katie Pei-Hsuan Wu;Li-Ching Lin;Johnny Chuieng-Yi Lu
    • Archives of Plastic Surgery
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    • v.49 no.6
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    • pp.769-772
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    • 2022
  • Femoral nerve injuries are devastating injuries that lead to paralysis of the quadriceps muscles, weakening knee extension to prohibit ambulation. We report a devastating case of electrical injury-induced femoral neuropathy, where no apparent site of nerve disruption can be identified, thus inhibiting the traditional choices of nerve reconstruction such as nerve repair, grafting, or transfer. Concomitant spinal cord injury resulted in spastic myopathy of the antagonist muscles that further restricted knee extension. Our strategy was to perform (1) supercharge end-to-side technique (SETS) to augment the function of target muscles and (2) fractional tendon lengthening to release the spastic muscles. Dramatic postoperative improvement in passive and active range of motion highlights the effectiveness of this strategy to manage partial femoral nerve injuries.

Effects of Intramedullary K-wire Insertion on Femoral Lengthening in Canine with Monolateral External Fixator (단측성 외고정 기구를 이용한 개의 대퇴골 신연에 있어서 골수강내 K-강선 삽입의 효과)

  • Hwang, Jae-Min;Kim, Young-Ki;Chin, Hee-Tec;Seok, Seong-Hoon;Lee, Hee-Chun;Koh, Phil-Ok;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.291-299
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    • 2006
  • During long bone lengthening, there are many disadvantages including axial deviation, malalignment and re-fracture which are commonly encountered inspite of its proven abilities. To study the effects of intramedullary K-wire application on the lengthening of long bone, ten skeletally mature mongrel dogs were separated into two groups(Group I, II). Right femurs of group I(5 dogs) were fixed with only monolateral external fixator after subperiosteal osteotomy. Right femurs of group II(5 dogs) were fixed with mono lateral external fixator and intramedullary K-wire after subperiosteal osteotomy. Lengthening was started at 7 days after the surgery with the rate of 0.5 mm per day for 5 weeks and the dogs were sacrificed after 15 weeks postoperatively to examine histologic differences and evaluate bone mineral density. Radiographic examination at an interval of two weeks was done to evaluate the type of callus formed and to analyze complications including instability of external skeletal fixation and axial deviation. Bone mineral density at the lengthened area and contralateral nonlengthened area were measured using quantitative computerized tomography. Histological examination of regenerated bone was performed using Masson's trichrome stain method. The radiographs demonstrated poor callus formation, higher incidence of axial deviation and screw loosening in the group I compared to the group II. The bone mineral density at the lengthened area in the group II was higher than that of the group I(P<0.05). Histological examination showed that the new bone trabeculae in the group II were greater than that of the group I. In conclusion, the combination of monolateral external fixator and intramedullary K-wire can prevent pin loosening, axial deviation and reduce healing period in dogs.

Initial Lengthening Behavior of Cadaveric Achilles Tendon Graft After Posterior Cruciate Ligament Reconstruction (후방십자인대 재건술 후 사체 아킬레스 이식건의 초기연신거동)

  • Kim, Cheol-Woong;Bae, Ji-Hoon;Lee, Ho-Sang;Wang, Joon-Ho;Park, Jong-Woong;Oh, Dong-Joon
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.1461-1466
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    • 2008
  • In the case of Posterior Cruciate Ligament (PCL), the most frequent mechanism is the dashboard injury, which is directly pressurized to the anterior of the proximal tibia in the state of the knee hyperflexion. The PCL associated ligament damage happens when the posterior injury, the varus, the valgus, the hyperextension and the severe vagus torque are out of the critical value of PCL. After the successful operation cases of Anterior Cruciate Ligament (ACL) reconstruction using the allograft were informed from 1986, a number of results kept over the maximum 10 years were reported. Unfortunately, PCL reconstruction are crowded the surgery techniques such as the graft, the tibia fixing method, the fixation device, the location of the femoral tunnel, the number of the graft bundles and PCL reconstruction to access to the stability of the normal joint is being developed. Therefore, this study is the basic research of these above facts. The current transtibial tunnel surgery using the cadaveric Achilles tendon grafts is chosen for the various PCL reconstruction. The initial extension of the Achilles tendon by the fixing device and its location under the cyclic loading, were observed.

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Limb Salvage Surgery after Removal of Infected Tumor Prosthesis with Equalization of Leg Length (감염된 종양 대치물 제거와 하지 단축 보정 후 시행한 사지 구제술 - 증례 보고 -)

  • Kwon, Young-Ho;Kim, Jae-Do;Chung, So-Hak;Cho, Yool
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.141-147
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    • 2006
  • In 1996, a nine-year-old girl was treated with recycling autograft after wide resection of the distal femoral osteosarcoma. The leg lengthening and revision with growing tumor prosthesis were performed due to limb leg discrepancy and epiphyseal problem. However, deep infection developed after operation, and a temporary spacer with cement and Ender nail was inserted. After infection was controlled completely, the final leg lengthening was performed with mono-external fixator for limb length discrepancy (10 cm). Lastly, Tumor prosthesis was reinserted to preserve the joint function.

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Reconstruction of Mutilating Hand with Pollicization and Anteromedial Thigh Perforator Free Flap - A Case Report - (무지 형성술 및 전내측 대퇴부 천공지 피판의 연속 술기를 이용한 수부 절단 손상의 재건 - 증례 보고 -)

  • Lee, Hyun-Jic;Eo, Su-Rak;Cho, Sang-Hun
    • Archives of Reconstructive Microsurgery
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    • v.21 no.1
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    • pp.56-60
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    • 2012
  • Purpose: Thumb reconstruction plays most important role in hand injuries because total loss of a thumb constitutes about 40% disability in the hand. The reconstruction can be accomplished by pollicization, free toe-to-thumb transfer, wrap around procedure and lengthening extraction. However, we sometimes need consecutive or double free flaps in the reconstruction of mutilating hand injuries. Methods: We reconstructed a mutilating hand injury in a 54-years old man. Because of severe crushing injury of right thumb and index fingers, we reconstructed a thumb with pollicization using nearly amputated middle finger. Although it survived completely, the adjacent soft tissues which had been covered by fillet flap from the space past was necrosed on 1 month. We debrided the necrotic tissues and covered it with anteromedial thigh perforator free flap consecutively because he had an anatomical variation in branches of lateral femoral circumflex artery. Results: He had an uneventful postoperative course without any complication such as infection, dehiscence and flap necrosis. Three months later, he had undergone tenolysis and defatting procedure of flap site. He recovered the some amount of grip function and was happy with the result. Conclusion: In severe hand trauma including thumb amputation, thumb reconstruction using pollicization and perforator free flap could be an alternative option. It provides minimal donor site morbidity and an acceptable functional result.

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Transcatheter Arterial Embolization in the Treatment of Massive Hemoptysis (대량 객혈 환자에서 동맥 색전술의 치료 효과)

  • Choi, Wan-Young;Choi, Jin-Won;Lim, Byung-Sung;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Seo, Heung-Suk
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.1
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    • pp.35-41
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    • 1992
  • Background: Massive hemoptysis is a major clinical and surgical problem related to high motality. Bronchial and nonbronchial systemic arteries are considered to be the main source of hemoptysis. Embolization of these arteries has become an accepted treatment in the management of massive hemoptysis. Herein we evaluate the effect of arterial embolization in immediate control of massive hemoptysis and investigate the clinical and angiographic characteristics and the course of patients with recurrent hemoptysis after initial successful embolization. Method: 21 patients (15 men & women, aged 21 to 74 years) underwent transcatheter arterial embolization for the treatment of life-threatening massive hemoptysis from Jan 1988 to July 1991. Seven patients had inactive residual pulmonary tuberculosis, 5 cases aspergilloma, 4 cases active pulmonary tuberculosis, 3 cases bronchiectasis and 2 case lung cancer. Arteriography was done by percutaneous catheterization via the femoral artery, and at the same time, arterial embolization was done with gelfoam particle. Result: Immediate control of massive hemoptysis was achieved in all 21 cases by arterial embolization. Hemoptysis recurred in nine of 21 patients. Four cases were aspergilloma, two inactive tuberculosis, two lung cancer, and one bronchiectasis. The initial angiographic findings revealed that nonbronchial systemic arterial supply, bronchial-pulmonary arterial shunt, and marked vascularity were more frequently, but statistically insignificant, in recurred patients. The following complications occured: fever, chest pain, cough, voiding difficulty, paralytic ileus, paraplegia, and splenic infarction. The course of the recurred patients was as follows: Three patients were died due to recurred massive hemoptysis. one was aspergilloma and two lung cancer. Surgical resection could be performed successfully in two patient with relatively good lung function, one aspergilloma and the other inactive tuberculosis. In 4 patients with poor lung function, repeated embolization or medical conservative treatment was continued. Conclusion: Arterial embolization as initial treatment of massive hemoptysis is most useful and relatively safe, although this is a palliative procedure and the potentiality for recurrence exists. Repeated embolization in inoperable patient with recurrent bleeding may improve the lengthening of life.

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