• Archives of Plastic Surgery
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• v.38 no.5
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• pp.655-662
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• 2011

Purpose: The anterolateral thigh flap is versatile flap for soft-tissue reconstruction for defects located at various sites of the body. This useful flap offers a thick and vascular fascia lata component with large amounts that can be soft tissue coverage for different reconstructive purposes. We present our clinical experience with the use of vascular fascia lata, combined with anterolateral thigh flap for various reconstructive goals. Methods: From April 2008 to February 2011, we transferred anterolateral thigh flaps with fascia lata component to reconstruct soft-tissue defects for different purposes in 11 patients. The fascia lata component of the flap was used for tendon gliding surface in hand/forearm reconstruction in 4 patients, for reconstruction medial and lateral patellar synovial membrane and retinaculum in 2 patients, for reconstruction of plantar aponeurosis in the foot in 2 patients, for reconstruction of fascial and peritoneal defect in the abdominal wall in 2 patient, and for dural defect reconstruction in the scalp in the remaining one. Results: Complete loss of the flap was not seen in all cases. Partial flap necrosis occurred in 2 patients. These complications were treated successfully with minimal surgical debridement and dressing. Infection occurred in 1 patient. In this case, intravenous antibiotics treatment was effective. Conclusion: Anterolateral thigh flap has thick vascular fascia with large amounts. This fascial component of the flap is useful for different reconstructive aims, such as for tendon, ligament, aponeurosis defects, abdominal wall or dura reconstruction. It should be considerated as an important advantage of the flap, together with other well-known advantages.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.1-9
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• 1998

From January 1985 to February 1997, 96 patients had undergone the free vascularized groin flap on the upper and lower extremities with microsurgical technique at the department of orthopaedic surgery, Yonsei University College of Medicine. The results were as follows: 1. Average age at the time of operation was 24.9 years. and there were 71 men and 25 women and mean follow up was 62.4 months. 2. The lesion site was 82 cases on the lower extremity: foot(40), leg(20), ankle(13), and 14 cases on the upper extremity: forearm(6), elbow(3), hand(3), wrist(2). 3. The anatomical classification of the superficial circumflex iliac artery was as follows: 1) 39.8% of common origin with superficial inferior epigastric artery, 2) 30.1% of isolated origin and absent superficial inferior epigastric artery, 3) 13.3% of separate origin, 4) 16.9% of origin from the deep femoral artery. 4. There was no statistical significance on arterial anastomosis between end to end and end to side, and on venous anastomosis(end to end) between one vein and two veins. 5. The success rate was average 84.4% in 81 of 96 cases. 6. In the 15 failed cases, the additional procedures were performed: 5 cases of free vascularized scapular flap, 6 cases of full thickness skin graft, 2 cases of cross leg flap, 1 case of latissimus dorsi flap, 1 case of split thickness skin graft. In conclusion, the free vascularized groin flap can be considered as the treatment of choice for the reconstruction of the extensive soft tissue injury on the extremities, and show the higher success rate with the experienced surgeon.

• Fashion & Textile Research Journal
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• v.21 no.4
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• pp.488-496
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• 2019

This study investigated if the proper pressure level on the wrist tendon area and muscle area of the lower arm are within the same range by examining the responses of blood flow and subjective evaluation. Subjects consisted of 18 males in their 20s, and the experimental bands were custom-made by applying size measurements of each subject. In the experiment, a total of 5 steps were selected by reducing 10 (Step 1) to 50 (Step 5)% from the original body size in the circumferential direction. Blood flow was measured with a sensor attached to the tip of the finger inside the right hand while sitting in a chair for 15 minutes. Blood velocity began to increase (0.82 kPa) when the wrist circumference around tendon area was reduced by 20% (Step 2) and reached its maximum (1.72 kPa) at Step 4. However, the preferred subjective pressure was 1.36 kPa, which was less than the maximum pressure value of 1.72 kPa for Step 4. Blood velocity began to increase when pressure on the muscle area was 1.38 kPa and reached its maximum at 2.16 kPa; however, the most preferred clothing pressure was 1.71 kPa. The results of this study showed that the appropriate pressure level was higher in the muscle area than in the wrist tendon of the lower arm and indicated that graduated compression is favorable.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.468-478
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• 2018

Background: The restriction of wrist motion results in limited hand function, and the evaluation of the range of wrist motion is related to the evaluation of wrist function. To analyze and compare the wrist motion during four selected tasks, we developed a new desktop motion analysis system using the motion controller for a home video game console. Methods: Eighteen healthy, right-handed subjects performed 15 trials of selective tasks (dart throwing, hammering, circumduction, and winding thread on a reel) with both wrists. The signals of light-emitting diode markers attached to the hand and forearm were detected by the optic receptor in the motion controller. We compared the results between both wrists and between motions with similar motion paths. Results: The parameters (range of motion, offset, coupling, and orientations of the oblique plane) for wrist motion were not significantly different between both wrists, except for radioulnar deviation for hammering and the orientation for thread winding. In each wrist, the ranges for hammering were larger than those for dart throwing. The offsets and the orientations of the oblique plane were not significantly different between circumduction and thread winding. Conclusions: The results for the parameters of dart throwing, hammering, and circumduction of our motion analysis system using the motion controller were considerably similar to those of the previous studies with three-dimensional reconstruction with computed tomography, electrogoniometer, and motion capture system. Therefore, our system may be a cost-effective and simple method for wrist motion analysis.

• Archives of Craniofacial Surgery
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• v.20 no.1
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• pp.37-43
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• 2019

Background: Tongue reconstruction is challenging with the unique function and anatomy. Goals for reconstruction differ depending on the extent of reconstruction. Thin and pliable flaps are useful for tongue tip reconstruction, for appearance and mobility. This study reports lateral arm free flap (LAFF) as a safe and optimal option for hemi-tongue reconstruction, especially for tongue tip after hemiglossectomy. Methods: Thirteen LAFFs were performed for hemi-tongue reconstruction after hemiglossectomy from 1995 to 2018. Of the 13 patients, seven were male and six were female, age varying from 24 to 64 years. Results: All flaps healed uneventfully without complications. Donor sites were closed primarily. The recipient vessels for microvascular anastomosis were mainly superior thyroidal artery, external jugular vein. All patients returned to normal diet, with no complaints regarding reconstructed tongue and donor site. Conclusion: The LAFF is hairless, thin (especially with lateral epicondyle approach), and potentially sensate. They are advantageous features for tongue tip and hemi-tongue reconstruction. Donor site sacrifices the inessential posterior radial collateral artery, and the scar is hidden under short sleeve shirts. We believe that LAFF can be considered as the first choice flap for hemitongue reconstruction, over radial forearm free flaps.

• Korean Circulation Journal
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• v.48 no.12
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• pp.1120-1130
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• 2018

Background and Objectives: Feasibility of coronary angiography (CAG) and percutaneous coronary intervention (PCI) via left snuffbox approach is still concerned. We aimed to investigate efficacy and safety of the left snuffbox approach for CAG and PCI. Methods: Left snuffbox approach was tried in 150 patients who planned to perform CAG or PCI for suspected myocardial ischemia between 1 November 2017 and 31 March 2018. Results: Success rate of radial artery (RA) cannulation via snuffbox approach was 88.0% (n=132). Among 132 individuals, 58 (43.9%) acute coronary syndrome (ACS) patients were included. The diameter of snuffbox RA was significantly smaller than conventional RA (2.57 mm vs. 2.72 mm, p<0.001) from quantitative computed angiography of 101 patients. However, CAG via snuffbox approach by 6 French sheath was successfully performed in all 132 patients. In addition, there was significant correlation between the snuffbox and conventional RA diameter (r=0.856, p<0.001). In 42 PCI cases, including 25 patients with acute myocardial infarction (AMI), the success rate of PCI via snuffbox approach was 97.6% (n=41). Intravascular imaging-guided PCI was performed in 8 (19.5%) patients and multi-vessel PCI in 4 (9.8%) cases. Regarding vascular complication, forearm swelling with bruising, not requiring surgery or transfusion, occurred in 2 (4.9%) PCI cases. Conclusions: Left snuffbox approach is suitable for CAG and PCI compared with the conventional radial approach.

• PNF and Movement
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• v.19 no.1
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• pp.147-152
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• 2021

Purpose: This study was conducted to investigate the functional differences of the two heads of the biceps brachii by measuring the functions in supination according to pronation by the angle of the flexion of the elbow joint, except for the activities of the elbow flexors. Methods: This study was conducted with 25 healthy men in their 20s. At a glenohumeral-joint 0˚ flexion posture, angles of flexion of the elbow joint of 0˚, 30˚, 60˚, 90˚, and 120˚ were randomly provided, and they were asked to perform supination and pronation with an elastic band. Using an eight-channel surface electromyogram, the muscle activities of the long and short heads of the biceps brachii were measured. The activities of the short and long heads according to the angle were analyzed using a one-way ANOVA, and as a post-test, LSD was employed. Results: The analysis of the impact of the resistance of the elastic band in supination on the differences in the muscle activities in the short and long heads suggests there was a significant difference between 0˚ and 30˚ (p < 0.05). Conclusion: In supination according to forearm pronation, the long head had greater action in the early flexion posture of the elbow joint, and it is judged that the ratio of the flexion of the elbow joint according to the actions of the biceps brachii was considered small.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.33-40
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• 2021

Purpose : The fascia is the body's largest sensory organ affected by mechanical stimuli such as pressure. Fascial distortion model (FDM) is one of the fascia treatment techniques, and it is based that most musculoskeletal problems are caused by three-dimensional distortion of the fascia. Until now, some studies have been conducted to investigate the effect of FDM, but it is still not enough. In this study, among the six techniques of FDM, trigger band (TB) and cylinder distortion (CyD) were applied to the forearm to investigate the immediate effect on the maximal grip strength, force sense and range of motion. Methods : 22 healthy adults in their 20s and 30s participated. Before and after the application of FDM, maximal grip strength, force sense and range of motion were measured. For analysis, a paired t-test was performed, and the significance level was set to p<.05. Results : After FDM, there were a significant differences that increased the force sense and the range of motion (p<.05). But the maximal grip strength did not show a significant difference (p>.05). Conclusion : The results of this study, the FDM did not affect maximal grip strength, but it was shown to increase the sense of force and range of motion. We assumed that it is the result of the changes in the states of the fascia and changes in the activity of mechanical receptors induced by pressure and stretch from FDM application.

• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.271-275
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• 2020

Trauma is frequently implicated in the development of sarcomas, including rhabdomyosarcoma. Rare soft tissue sarcomas have been reported to arise in scar tissue following surgical procedures or thermal or acid burns, at fracture sites, and in the vicinity of plastic or metal implants, usually after a latent period of several years. The authors encountered a case of a rhabdomyosarcoma arising from the forearm crushed by a conveyor belt 11 years ago. Several possible etiological factors for sarcoma development were identified in this patient, including tissue damage and inflammation, as well as the presence of metal implants and the limb's exposure to radiation during multiple imaging tests. After severe soft tissue damage, the occurrence of a sarcoma should be considered and more attention should be paid to the causative factors for sarcoma.

• Archives of Plastic Surgery
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• v.49 no.5
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• pp.617-632
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• 2022

Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.