• Title/Summary/Keyword: forearm

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Comparison Study Between Coverage Choices for Radial Forearm Free Flap Donor Site (전완유리피판 공여부 재건에서 전층 피부이식술과 부분층 피부이식술의 비교)

  • Jeong, Woo Shik;Choi, Jong Woo;Oh, Tae Suk
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.1
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    • pp.5-8
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    • 2015
  • Backgrounds: The purpose of this study was to compare full thickness skin graft with inguinal skin to split thickness skin graft for coverage of the radial forearm free flap donor site. Patients and Methods: 25 patients who was reconstructed with radial forearm free flap for head and neck cancer were reviewed retrospectively. Results: The graft loss rates of full thickness skin graft were less than split thickness skin graft or split thickness skin graft with dermal substitutes. The recovery times of donor site and skin graft donor site of full thickness skin graft were also shorter than split thickness skin graft or split thickness skin graft with dermal substitutes. Skin texture and aesthetic results of donor site were improved and complications as itching and pain sensation were decreased. Conclusion: Full thickness skin grafts with inguinal skin should be considered for patients requiring a radial forearm free flap.

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Treatment of Urethral Stricture using Sensated Ulnar Forearm Free Flap (척골측 전완부 감각유리 피판술을 이용한 요도협착의 치료)

  • Hur, Jae-Young;Lee, Hoon-Bum;Tark, Kwan-Chul
    • Archives of Reconstructive Microsurgery
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    • v.10 no.2
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    • pp.81-85
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    • 2001
  • In the treatment of urethral stricture, many problems still remain with the current methods making it a field of further exploration for reconstructive surgeon. Furthermore, when total or multiple strictures of the penile urethra exist, the methods of surgery become difficult due to a necessity for a long neourethra. Introduction of vascularized free flap has broadened the choice and improved the results of reconstruction for the urethra. The authors used a sensate ulnar forearm free flap in a patient with multiple penile urethral strictures for reconstruction. Uroflowmetry, 30 months after surgery, revealed that maximal flow rate was 15.5 ml/sec, average flow rate was 9.5 ml/sec, and voided volume was 157 ml. A urethrogram was performed 30 months postoperatively and a good result was achieved. The ulnar forearm free flap used by the authors are thin and pliable and is good for providing sufficient length to reconstruct the neourethra for a long urethral defect.

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APPLICATION OF ARTIFICIAL DERMIS($Terudermis^{(R)}$) AND SPLIT THICKNESS SKIN GRAFT ON THE DONOR SITE OF RADIAL FOREARM FLAP (인공진피($Terudermis^{(R)}$)와 부분층 피부이식을 이용한 전완피판 공여부 수복)

  • Oh, Jung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.3
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    • pp.227-232
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    • 2007
  • The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.

Limitation of Forearm Rotation after Tension Band Fixation in Olecranon Fracture - Case Report - (장력대 강선 고정법을 이용한 주두 골절의 수술적 치료 후 전완부의 회전운동 제한 - 증례보고 -)

  • Roh, Kwon-Jae;Lee, Churl-Woo;Yun, Yeo-Hon;Shin, Sang-Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.2
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    • pp.133-137
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    • 2005
  • Tension band wiring of olecranon fractures is recognized as an effective method for fixation and union Complications as non-union, limitation of motion and subcutaneous k-wire protrusion are occasionally reported. But, there are no references about limitation of forearm rotation after tension band fixation. We report two cases of limitation of forearm rotation after tension band fixation of olecranon fracture.

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Flexor Carpi Radialis Tendon Rupture due to Repetitive Golf Swing (반복적인 골프 스윙으로 인한 노쪽손목굽힘근 힘줄의 파열)

  • Lee, Sang Chul;Koh, Sung Hoon;Jang, Jin Hyuk;Ahn, Jae Ki
    • Clinical Pain
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    • v.18 no.2
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    • pp.107-110
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    • 2019
  • Flexor carpi radialis (FCR) muscle is located in the forearm anteriorly that runs through a synovial fibro-osseous tunnel in the forearm. We described a case of FCR tendon rupture due to repetitive overuse injury. A 55-year-old man, right-hand dominant, presented with right forearm pain and swelling which started 3 days ago while playing amateur golf. Focal tenderness and bruising over volo-ulnar region of the right forearm were examined. Plain radiographs showed soft tissue edema around lesion area and no detectable fracture. Ultrasonography showed multiple hypoechoic lesions suspected as hematoma of the flexor muscle group. After done magnetic resonance imaging, he was diagnosed with rupture of FCR tendon at proximal origin and strain of flexor digitorum superficialis and palmaris longus muscle. He received compressive dressing and restriction of wrist range of motion for three weeks. Two months later, remaining traces of lesions were observed at the follow-up ultrasonography and the pain disappeared.

Treatment of Talipes Equinus Deformity Using Free Radial Forearm Flap and Achilles Tendon Lengthening (아킬레스건 신장술과 유리 전완부 피판술을 이용한 첨족 장애의 치료)

  • Kim, Dae Seung;Lee, Jong Wook;Ko, Jang Hyu;Seo, Dong Kook;Choi, Jai Ku;Jang, Young Chul;Oh, Suk Joon
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.593-598
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    • 2007
  • Purpose: Talipes equinus deformity is defined as impossibility of heel weight-bearing and lacking of improvement of toe-tip gait despite sufficient duration of conservative treatment. The incidence of equinus deformity induces post-traumatic extensive soft tissue defect and subsequently increases it. Severe equinus deformities of the foot associated with extensive scarring of the leg and ankle were corrected using achilles Z-lengthening and free-tissue transfer. Methods: Free radial forearm flap was done in nine cases of eight patients from January 2000 to November 2006. Causes of deformity were post-traumatic contracture (one patient) and post-burn scar contracture (seven patients). Seven patients were male, one patient was female. Mean age was 32.1 (range, 10-57). Flap donors were covered with artificial dermis ($Terudermis^{(R)}$) and split thickness skin graft (five cases), and medium thickness skin graft only (four cases). Results: The size of flaps varied from $6{\times}12$ to $15{\times}12cm$ (average, $12{\times}7.8cm$). Achilles tendon was lengthened 4.2cm on average. Free radial forearm flap was satisfactory in all cases. All patients could ambulate normally after the surgery. Cases having donor coverage with $Terudermis^{(R)}$ were aesthetically better than those having skin grafts only. Conclusion: This study suggested that severe equinus deformities associated with extensive scarring of the leg and ankle can be corrected effectively free radial forearm flap and Achilles tendon lengthening.

The Relationship between Bone Mineral Density and Body Composition, Life Styles of Female College Students (여대생의 골밀도와 신체조성 및 생활습관과의 관계 연구)

  • Lee, Jong-Hyun;Lee, Bo-Kyung;Kim, Young-Soon
    • The Korean Journal of Food And Nutrition
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    • v.24 no.4
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    • pp.786-796
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    • 2011
  • The purpose of this study was to investigate the relationship between bone mineral density(BMD), body composition and life styles of female college students. The subjects were 334 students with a mean age of 21.0 years. BMDs of forearm and calcaneus were measured by dual energy X-ray absorptiometry, and body composition was measured by bioelectrical impedence analysis. The means for weight, height, and body mass index(BMI) of the subjects were 55.7 kg, 161.0 cm, 21.5 kg/$m^2$, respectively. Grouping by the BMI, 13.2% of the subjects were classified as overweight, and 11.1% of the subjects as obese group. BMD in the forearm and calcaneus were 0.390 g/$cm^2$, 0.514 g/$cm^2$. In the forearm, 58.1% and 9.6% of the subjects were classified as osteopenia and osteoporosis, respectively, and in the calcaneus, 12.0% and 0.3% of the subjects were classified as osteopenia and osteoporosis, respectively. Body weight, skeletal muscle mass, lean body mass, fat mass and BMI were positively correlated with BMDs in the forearm and calcaneus($r$=0.180~0.495, $p$ <0.01~0.001), and height, % body fat and waist-hip ratio(WHR) were positively correlated with BMDs in the calcaneus($r$=0.213~0.239, $p$ <0.001), but not in the forearm. The factors such as beginning age of cigarette smoking and alcohol drinking and exercise had significant influence on BMD($p$ <0.05; p<0.001), whereas sleeping hours, activity level, frequency of exercise, meal times, frequency of snack and fried food intake, breakfast skipping and amount of meal had not significant influence on BMD. Therefore, the acquisition of balanced body composition is necessary through the increase of fat free mass and muscle mass, not through the increase of fat mass among female college students.

Reconstruction of Hypopharynx and Cervical Esophagus : Choice of Flap (하인두 및 경부식도 결손의 재건 : 재건술의 선택)

  • Choi Eun-Chang;Lee Sei-Young;Chung Tae-Young;Kim Se-Heon;Kim Young-Ho;Ryu Dae-Hyun;Kim Choong-Bae
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.26-32
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    • 2000
  • Background and Objectives: Various flaps are using for reconstruction of hypopharyngeal and esophageal defect. However, complication and indication of each flap are not fully analyzed. Patient and Methods: Records of 52 hypopharyngeal cancer patients who had surgical treatment and 13 other head and neck cancer patients who underwent hypopharyngeal and/or esophageal reconstruction with flap were retrospectively analyzed. Eighty three percent(54 cases) of patients needed reconstruction other than primary pharyngeal closure. Five split thickness skin graft, 1 pectoralis major myocutaneous flap, 20 forearm free flap, 13 jejunal free flap, 15 gastric pull up were used. Result: Flap failure was noted in 2 cases who had subsequent gastric transposition. Wound dehiscence and fistula were most common problem of forearm free flap. Most fistulas were developed in patients with conduit type reconstruction of forearm flap while there wasn't any fistula in patient with patch type reconstruction. Stenosis of lower anastomosis was the frequent problem of jejunal transfer. Gastric pull-up has frequent com-plication of stomal stenosis. All but three patients had reached oral feeding postoperatively. Conclusion: Based on this study, forearm flap is effective in partial hypopharyngeal defect while jejunum is the choice for circumferential defect. Gastric pull-up is for combined esophageal defect.

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Reconstruction of Through and Through Defect of the Cheek After Resection of Buccal Mucosa Cancer (협점막암 절제후 협부관통결손의 재건방법에 대한 고찰)

  • Choi Eun-Chang;Kim Eun-Seo;Hong Won-Pyo
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.1
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    • pp.47-55
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    • 1995
  • A large lateral facial defects especially a through and through defect of the cheek remains as challenging field of reconstruction for the head and neck surgeons. Closure of these wounds is technically troublesome due to the magnitude and location of the soft tissue and skin defect, functional and aesthetic consideration. optimal cancer surveillance, and desire for good nourishment. Most traditional methods dealing with these defects, including split-thickness skin graft, local and regional flaps as well as musculocutaneous flaps have their limitations. We applied four different methods for these reconstruction in four cases. We utilized temporal muscle flap, forearm free flap and secondary healing for repair of mucosal defects, and medial base cervicopectoral flap, pectoralis major myocutaneous flap and cervicofacial flap for the reconstruction of external skin defects. In one case, both sides were reconstructed with single forearm free flap. In our experiences, secondary healing could be one of the useful method for mucosal repair in the defect between upper and lower gingivobuccal sulcus. However, forearm free flap was thought to be more ideal for the cases with mandibulectomy. For the external repair, the regional skin flap was considered to be superior to pectoralis major myocutaneous flap or forearm free flap especially on color matching.

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Glottic and Pharyngeal Recostruction Using Radial Forearm Free Flap with Palmaris Longus Tendon (장장근건과 전완유리피판술을 이용한 성대.인두재건술)

  • Lee Jong-Woo;Park Kyong-Ho;Lee Keon-Sok;Cho Seong-Ho;Kim Min-Sik
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.198-204
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    • 2001
  • Background and Objectives: As the laryngopharyngeal cancer is usually found at a advanced stage, it is difficult to get a wide surgical margin that preserves functional aspect and that is oncologically safe simultaneously. There were many operative technique to fulfill this principle, but none were satisfactory. Recently there were some reports about glottic and pharyngeal reconstruction using radial forearm free flap(RFFF) with palmaris longus tendon, which provided satisfactory oncologic and functional results. We attempted to perform this technique and to test usefulness at patients of laterally localized laryngopharyngeal tumor. Materials and Methods: Three patients were reconstructed glottis and pharynx using radial forearm free flap with palmaris longus tendon. Two hypopharyngeal cancer (T2N0M0) patients were performed wide vertical hemilaryngopharyngectomy and one supraglottic cancer(T2N0M0) patient was performed horizontovertical laryngopharyngectomy. Deglutitional function was evaluated with modified barium swallow and speech function was evaluated by speech pathologist. Results: Mean follow-up time was 29.3 months. There were no cancer recurrence. Their speech was satisfy-actory at social communication and oral feeding. They all have a complete oral nutrition from 26 days to 53 days. Decanulation time was from 71 days to 30 months. Conclusion: Glottic and pharyngeal reconstruction with radial forearm free flap could be accepted as a promising technique which offers a wide resection margin but satisfactory functional result in lateralized laryngohypopharyngeal cancer patients.

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