• 대한두경부종양학회지
• /
• 제19권1호
• /
• pp.41-46
• /
• 2003

Background and Objectives: Surgical ablation of tumors in the oral cavity and the oropharynx results in a three dimensional defect because of the needs to resect the adjacent area for the surgical margin. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for this defect, which offers a thin, pliable, and relatively hairless skin and a long vascular pedicle. We report the clinical results of our 54 consecutive radial forearm free flaps used for oral cavity and oropharynx cancers. Materials and Methods: We reviewed the medical records of patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for oral cavity and oropharyngeal cancers from August 1994 to February 2003 and analyzed surgical methods, flap survival rate, complication, and functional results. Among these, 20 cases were examined with modified barium swallow to evaluate postoperative swallowing function and other 8 cases with articulation and resonance test for speech. We examined recovery of sensation with two-point discrimination test in 15 cases who were offered sensate flaps. Results: The primary sites were as follows : mobile tongue (18), tonsil (17), floor of mouth (4), base of tongue (2), soft palate (2), retromolar trigone (3), buccal mucosa (1), oro-hypopharynx (6), and lower lip (1). The paddles of flaps were tailored in multilobed designs from oval shape to tetralobed design and in variable size according to the defects after ablation. This procedures resulted in satisfactory flap success rate (96.3%) and showed good swallowing function and social speech. Eight of 15 cases (53.3%) who had offered sensate flap showed recovery of sensation between 1 and 6 postoperative months (average 2.6 month). Conclusion: The reconstruction with radial forearm free flap might be an excellent method for the maximal functional results after ablative surgery of oral cavity and oropharyngeal cancers that results in multidimensional defect.

• 한국정밀공학회:학술대회논문집
• /
• 한국정밀공학회 2013년도 춘계학술대회 논문집
• /
• pp.1619-1620
• /
• 2013

• 대한미세수술학회:학술대회논문집
• /
• 대한미세수술학회 1997년도 제17차 학술대회
• /
• pp.130.1-130.1
• /
• 1997

• 대한인간공학회:학술대회논문집
• /
• 대한인간공학회 1996년도 춘계학술대회논문집
• /
• pp.291-300
• /
• 1996

This study is to determine the biomechanical characteristics of Korean. Male 58 and Female 54 were participated for the measurement which was performed by immersion method and reaction board method. Body parts were head with neck, trunk, upper arm, forearm, hand, thigh, leg, and foot. Their volumes were measures by immersion method. Their weight were determined by using Dempster(1995), Drills and Contini(1969) density data. Each center of body part weight were determined by specific posture on the reaction board. The postures were asked to the subject forearm- lifted posture, total let- lifted posture, foot-lifted posture. According to each posture, the center of each part were calculated.

• 디지털융복합연구
• /
• 제11권12호
• /
• pp.551-556
• /
• 2013

전완부와 요추부의 골밀도 검사를 통해 얻은 골밀도 값, T-score 와 Z-score 수치간의 상관관계 및 보정함수를 구해 어느 한 부위의 결과로서 다른 부위의 결과를 유추하는데 목적이 있다. 환자 66명은 연령별로 11명씩 20대에서 70대까지 환자들로 구성하였고 측정된 전완부와 요추부의 골밀도와 T-score와 Z-score를 조사하여 세가지 사항들에 대해 각각 상관관계가 있는지 평가하고 그 상관관계를 구하여 보정계수를 찾는다. 골밀도의 상관계수는 R=0.769 이고 보정계수 식은 Y=1.541X + 0.133 이다. T-score의 상관계수는 R=0.768 이고 보정계수식은 Y=0.715X - 0.4 이다. Z-score의 상관계수는 R=0.635 보정계수식은 Y=0.751X - 0.162 이다. 상관관계와 보정계수식를 통해 어느 한 부위의 결과로서 다른 부위의 결과를 유추할 수 있는 임상적 유용성이 있을 것으로 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제35권4호
• /
• pp.248-255
• /
• 2013

Reconstruction techniques of orofacial defects caused by wide excision of the intraoral malignant lesions are various. Although radial forearm free flap is a common donor site on reconstruction of soft tissue defect, anterolateral thigh (ALT) free flap also has an established site in orofacial soft tissue reconstruction as the favored donor flap with recent progress of the microsurgical technique. A 59-year-old female complained of hyperplastic mass on the right retromolar and buccal cheek, which was diagnosed as a squamous cell carcinoma (SCC) by an incisional biopsy. Before the operation, we planned a wide excision of the SCC lesion, supraomohyoid neck dissection, reconstruction with radial forearm free flap (RFFF), and split thickness skin graft. We accidentally found an arterial variation of the forearm area during elevation of RFFF, and changed the plan of reconstruction operation to reconstruction with ALT free flap. Operative sites was healed well during the post-operative period, and we referred to the department of radiation oncology for post-operative radiotherapy.

• Archives of Reconstructive Microsurgery
• /
• 제10권2호
• /
• pp.131-136
• /
• 2001

Purpose : The sensory radial forearm flap is used to recover the soft tissue defect of hand and foot. The aim of this study is to evaluate the results after sensory reconstruction using sensate radial forearm flaps. Materials and Methods : There were 9 cases of 8 patients (6 males and 2 females). The 7 cases of 6 patients were donated to foot, the 2 cases of 2 patients to hand. At operation, the ages of them ranged from 18 to 63 years (mean: 37.9 years). Sensory evaluation was performed using percentage(%) of responding area to the pinprick test and the static and moving two-point discrimination test (s-2PD and m-2PD). Results : The mean percentage of responding area to the pin prick test was 48.5%. The mean s-2PD and m-2PD of recipient hands were 37.2 mm and 28.8 mm. The mean s-2PD and m-2PD of recipient feet were 46.7 mm and 45.0 mm. The mean s-2PD and m-2PD of controls were 23.5 mm and 19.7 mm. Conclusion : All the recipients were less sensitive than the control, but the recipient hands more sensitive than the recipient feet. Although the small numbers were studied, the results suggested that the recovery of sensation in the innervated flaps was influenced by the recipient nerve. So the donor nerve seems to be selected as more sensitive and more distal nerve of donor site for better outcome.

• Archives of Reconstructive Microsurgery
• /
• 제9권2호
• /
• pp.172-178
• /
• 2000

With esthetic concern in the reconstruction of skin and soft tissue defects of face, the use of local flap has been the method of choice. However, when there is extensive tissue loss in the face, local flaps do not provide satisfactory results. The amazing development of microsurgical technique has decreased the percentage of free flap failure, thus making free flap use in reconstruction of facial soft tissue defects. Many free flaps has been applied for reconstruction of face defects. Especially, the radial forearm flap has numerous advantages with which facial reconstruction is made possible. But, its disadvantages are ; the sacrifice of one major artery supplying the hand and donor site complications. In order to circumvent these disadvantages, we employed posterior interosseous artery(PIA) forearm free flap for the reconstruction of the face defects. The posterior interosseous forearm island flap was first described by Zancolli and Angrigiani(1985). Currently, the PIA island flap and free flap have been used for hand reconstructions. The disadvantages of the PIA flap are ; the small caliber of the pedicle, different locations of the perforating branches, and the proximity of the motor branch of the radial nerve. But, its advantages lies in preserving the major artery of the hand, minimal donor site morbidity, and fairly well matched skin texture and color, and that the flap volume is sufficient, not too bulky with convenient handling. By using this flap, we performed 1 case of tumor resection and 1 case of traumatic defect. From our experiences we conclude that it is one of many useful methods in the reconstruction of the skin and soft tissue defects of the face. We also have discussed advantages and some limitations of various free flaps for reconstruction of the face.

• 대한골관절종양학회지
• /
• 제14권2호
• /
• pp.146-151
• /
• 2008

근골격계와 소화기계에 동반된 다발성 원발성 종양은 매우 드물다. 52세 남자 환자에서 전완부의 점액섬유육종과 직장의 선암이 동반된 동시성 이중성 원발성종양이 발견되었다. 환자는 1년전부터 발생한 전완부의 통증 및 부종을 주소로 내원하였다. 전완부의 병변은 조직학적으로 점액섬유육종으로 확진되었다. 전신적 검사상 결장경 검사에서 직장의 선암이 발견되었으며 CT 검사상 폐로의 전이와 심장내 종양이 발견되었다. 병리학적 확정진단 후에 전완부의 수술적 절제술과 술 전,후 항암화학요법을 시행하였으며, 환자는 술 후 2달 후에 종양 색전에 의한 폐동맥혈전색전증으로 사망하였다. 저자들은 매우 드문 근골격계와 소화기계에 동반된 다발성 원발성 종양 1례를 경험하였기에 이를 문헌고찰과 함께 보고하고자 한다.

• Archives of Plastic Surgery
• /
• 제45권6호
• /
• pp.495-503
• /
• 2018

With significant improvements in success rates for free flap reconstruction of the head and neck, attention has turned to donor site morbidity associated with osteocutaneous free flaps. In this review, we address the morbidity associated with harvest of the four most commonly used osteocutaneous flaps; the free fibula flap, the scapula flap, the iliac crest flap and the radial forearm flap. A comprehensive literature search was performed to identify articles relevant to donor site morbidity for these flaps. We assessed morbidity in terms of incidence of delayed healing, chronic pain, aesthetic outcomes, site specific complications and patient satisfaction/quality of life. Weighted means were calculated when sufficient studies were available for review. The radial forearm and free fibula flaps are associated with high rates of delayed healing of approximately 20% compared to the scapular (<10%) and iliac flaps (5%). The radial forearm flap has higher rates of chronic pain (16.7%) and dissatisfaction with scar appearance (33%). For the majority of these patients harvest of one of these four osteocutaneous does not limit daily function at long-term follow-up. The scapular osteocutaneous flap is associated with the lowest relative morbidity and should be strongly considered when the recipient defect allows. The radial forearm is associated with higher morbidity in terms of scarring, fractures, chronic pain and wrist function and should not be considered as first choice when other flap options are available.