• Title/Summary/Keyword: tendon transfer

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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.

Optimization of Active Tendon Controlled Structures by Efficient Solution of LQR Control Gain (LQR 제어이득의 효율적 산정에 의한 능동텐던 구조물의 최적화)

  • Cho, Chang-Geun;Kyun, Jun-Myong;Jung, In-Kju;Park, Moon-Ho
    • Journal of Korean Association for Spatial Structures
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    • v.8 no.4
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    • pp.73-80
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    • 2008
  • The objective of current study is to develop an optimization technique for the seismic actively controlled building structures using active tendon devices by an efficient solution of LQR control gain. In order to solve the active control system, the Ricatti closed-loop algorithm has been applied, and the state vector has been formulated by the transfer matrix and solved by a numerical technique of the trapezoidal rule. The time-delay problem has been also considered by phase compensation. To optimize the performance index, the ratio of the weighted matrix is the design variable, allowable story drift limits of IBC 2000 and tendon forces have been applied as restraint conditions, and the optimum control program has been developed with the algorithm of the SUMT technique. In examples of the optimization problem of eight stories shear buildings, it is evaluated that the optimum controlled building is more suitable in the control of earthquake response than the uncontrolled system and can reduce the performance index to compare with the controlled system with a constant ratio of the weighted matrix.

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Load Transfer Test of Spirally Reinforced Anchorage Zone for Banded Tendon Group (나선형 원형철근으로 보강된 집중배치 텐던 정착구역에 대한 하중전달시험)

  • Cho, Ah Sir;Kang, Thomas H.K.
    • Journal of Korean Association for Spatial Structures
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    • v.17 no.1
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    • pp.59-67
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    • 2017
  • In this study, load transfer tests based on KCI-PS101 were conducted to verify the performance of spiral anchorage zone reinforcement for banded post-tensioning (PT) monostrands. With results, the compressive strength of spiral reinforcement was increased by about 20% than that of specimens with two horizontal steel bars and 8% than that of U-shaped bars. Advanced spiral reinforcement for corner increases compressive strength and can resist the spalling forces or fall-out effect at the corner by shear. The ratio of maximum load to amount of steel of the spiral reinforcement is about twice than that of U-shaped reinforcement. With increase of compressive strength capacity and improvement of constructability, the spiral reinforcement is considered to have advantages of promoting the performance of PT anchorage zone compared to conventional methods.

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.

Reconstruction of the Extremities with the Dorsalis Pedis Free Flap (족 배 유리 피부판을 이용한 사지 재건술)

  • Lee, Jun-Mo;Kim, Moon-Kyu
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.77-83
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    • 1999
  • The skin on the dorsum of the foot is a source of the reliable thin and sensory cutaneous free tissue transplantation with or without tendon, bone and joint. A composite flap with attached vascularized tendon grafts for the combined loss of skin and tendon on the dorsum of the hand and foot offers an immediate one stage solution to this problem. The flap provides a very durable innervated tissue cover for the heel of the foot and the dorsum of the hand and an osteocutaneous transfer combined with the second metatarsal. The major dorsalis pedis artery is constant in size, but the first dorsal metatarsal artery is variable in size and location. The dorsal surface of the foot receives sensory innervation through the superficial peroneal nerve and the first web through the deep peroneal nerve. Authors had performed 5 dorsalis pedis free flap transplantation in the foot and hand at Department of Orthopedic Surgery, Chonbuk National University Hospital from August 1993 through August 1997 and followed up for the period of between 19 and 67 months until March 1999. The results were as follows 1. 5 cases dorsalis pedis free flap transfer to the foot(4 cases) and the hand(1 case) were performed and the recipient was foot dorsum and heel 2 cases each and hand dorsum 1 case. 2 All of 5 cases(100%) were survived from free flap transfer and recipient artery was dorsalis pedis artery(2 cases), anterior tibial artery(1 case), posterior tibial artery(1 case) and ulnar artery(1 case) and recipient veins were 2 in number except in the hand. 3. Long term follow up of the exterior and maceration was good and sensory recovery was poor 4. Donor site was covered with full thickness skin graft obtained from one or both inguinal areas at postoperative 3rd week and skin graft was taken good and no morbidity was showed.

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The Fire induced Thermal Stress Analysis of PC Box Bridge (PC Box교량의 화재에 대한 열응력해석)

  • 최창근;이계희;최인혁;김일곤
    • Proceedings of the Computational Structural Engineering Institute Conference
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    • 1998.10a
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    • pp.125-132
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    • 1998
  • In this study the fire, due to overturning of oil tanker on the bridge induced heat transfer analysis and thermal stress analysis are carried out. The results of analysis for fire history of 1 hour present very large thermal gradient near the surface. However, the temperature increase of tendon & rebar that is the main resistant member of bridge is not sufficient to change material properties. The Von-Mises yield criteria is used to calculate the depth of delamination, The depth of delamination is about 4cm at center of fire and this value is close to measured value.

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Prediction of load transfer depth for cost-effective design of ground anchors using FBG sensors embedded tendon and numerical analysis

  • Do, Tan Manh;Kim, Young-Sang
    • Geomechanics and Engineering
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    • v.10 no.6
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    • pp.737-755
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    • 2016
  • The load transfer depth of a ground anchor is the minimum length required to transfer the initial prestressing to the grout column through the bonded part. A thorough understanding of the mechanism of load transfer as well as accurate prediction of the load transfer depth are essential for designing an anchorage that has an adequate factor of safety and satisfies implicit economic criteria. In the current research, experimental and numerical studies were conducted to investigate the load transfer mechanism of ground anchors based on a series of laboratory and field load tests. Optical FBG sensors embedded in the central king cable of a seven-wire strand were successfully employed to monitor the changes in tensile force and its distribution along the tendons. Moreover, results from laboratory and in-situ pullout tests were compared with those from equivalent case studies simulated using the finite difference method in the FLAC 3D program. All the results obtained from the two proposed methods were remarkably consistent with respect to the load increments. They were similar not only in trend but also in magnitude and showed more consistency at higher pullout loading stages, especially the final loading stage. Furthermore, the estimated load transfer depth demonstrated a pronounced dependency on the surrounding ground condition, being shorter in hard ground conditions and longer in weaker ones. Finally, considering the safety factor and cost-effective design, the required bonded length of a ground anchor was formulated in terms of the load transfer depth.

Dynamic Upper Eyelid Reconstruction for Total Periorbital Soft Tissue Loss

  • Vathulya, Madhubari;Manohar, Nishank;Jagtap, Manish Pradip;Mago, Vishal;Jayaprakash, Praveen A.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.319-323
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    • 2022
  • Total eyelid defect comprises full-thickness loss of both upper and lower eyelids in a patient. It is a rare and devastating condition with serious implications related to vision, which mandates early and functional reconstruction when associated with intact globe. The primary goal is to give a stable coverage for orbital protection but at the same time provide a functional reconstruction of the defect, to allow for adequate mobility of the eyelids so that the patient's vision is restored to normal with minimal disability. When the defect is massive, and in the absence of loco-regional flaps, microvascular tissue transfer is needed. In this report we describe a radial-artery-based microvascular tissue transfer with a unique innovation utilizing the contralateral frontalis muscle to reconstruct a case of unilateral total upper and lower eyelid loss.

Iatrogenic Hallux varus deformity after Hallux valgus surgery (무지 외반증 수술 후 발생한 의인성 무지 내반증)

  • Lee, Kyung-Tai;Young, Ki-Won;Bae, Sang-Won;Bang, Yu-Sun;Kim, Do-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.101-108
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    • 2003
  • Purpose: To evaluate and analyze the incidence, clinical features, cause and surgical outcomes of iatrogenic hallux varus deformity after hallux valgus surgery. Materials and Methods: Twenty-six Hallux varus deformities after hallux valgus surgery were evaluated. Clinical tolerability, patient's satisfaction and the main causative factor for varus deformity were evaluated. Radiologically, we measured the 1st intermetatarsal angle and hallux valgus angle on pre- & postoperatively. Results: 10 cases of 26 varus deformities were clinically intolerable. The patients complaint of mainly cosmetic and shoe fitting problems rather than pain and the main cause of deformities were over-correction of 1 st intermetatarsal angle. Radiologically, the average 1st intermetatarsal angle was 2.4 degrees and the hallux valgus angle was -9.2 degrees. After varus correction surgery, the average follow up were 17 months and the average 1st intermetatarsal angle was 2.3 degrees and the hallux valgus angle was 2.7 degrees. The average score of AOFAS Hallux Metatarsophalangeal -Interphalangeal Scale was 91 points. Conclusion: The hallux varus deformity after hallux valgus surgery came from mainly overcorrection of 1 st intermetatarsal angle. The management composed of just observation, tendon transfer and fusion, and each method could get satifactory results with appropriate indication.

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Dynamic Behavior of Pretensioned Concrete Member during Detensioning (긴장재 절단에 따른 프리텐션 부재의 동적 거동 고찰)

  • Kim, Jangho;Mun, Do Young;Ji, Goangseup;Kim, Gyuseon
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.28 no.5A
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    • pp.747-756
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    • 2008
  • The purpose of this paper is to investigate the effect of the important parameters on the transfer length during the dynamic flame cutting of tendon experimentally. The considered parameters were strand diameter, concrete cover thickness, stirrup, debonding strand and release method. Ten pretensioned concete beam specimens were cast and tested. Time history curves for the axial strain of tendon were measured by electrical resistance strain gauges mounted on the strands. Experimental results indicated that large dynamic shock effects occurred near cut-end during the sudden release. The prestressing forces are dependent on the parameters above considered. The ratio of residual prestressing forces of 12.7 mm strands is greater than 15.2 mm strands. Using debonding strand and gradual release are more efficient for applying prestressing forces.