• Title/Summary/Keyword: tendon transfer

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Pollicization of the Middle Finger

  • Bahk, Sujin;Eo, Su Rak;Cho, Sang Hun;Jones, Neil Ford
    • Archives of Reconstructive Microsurgery
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    • v.24 no.2
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    • pp.62-67
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    • 2015
  • Purpose: Pollicization typically involves surgical migration of the index finger to the position of the thumb. This procedure facilitates the conversion of a useless hand into a well-functioning one in patients who are not amenable to the toe-to-hand transfer. However, middle finger pollicization has been rarely reported. Materials and Methods: We reconstructed a thumb by immediate pollicization of the remnants of the middle finger in two patients who sustained a tumor and a trauma, respectively. The former, after cancer ablation was performed, has not been reported literally, and the latter involved free devitalized pollicization of the middle finger using a microsurgical anastomosis. The distal third extensor communis tendon was sutured to the proximal extensor pollicis longus tendon and the distal flexor digitorum superficialis and profundus were sutured to the proximal flexor pollicis longus. The abductor pollicis brevis tendon was sutured to the distal end of the first palmar interosseous muscle. Coaptation of the third digital nerve and the superficial radial nerve branch was performed. Results: Patients showed uneventful postoperative courses without complication such as infection or finger necrosis. Based on the principles of pollicization, a wide range of pinch and grasp movements was successfully restored. They were pleased with the functional and cosmetic results. Conclusion: Although the index finger has been the digit of choice for pollicization, we could also use the middle finger on specific occasions. This procedure provides an excellent option for the reconstruction of a mutilated thumb and could be performed advantageously in a single step.

Study on Prediction Method for Spring-Induced Tension Responses of TLP (Springing을 고려한 TLP의 장력 예측 기법 연구)

  • Kim, Taeyoung;Kim, Yonghwan
    • Journal of Ocean Engineering and Technology
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    • v.28 no.5
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    • pp.396-403
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    • 2014
  • This paper considered the prediction of the tension force in the design of a TLP tendon, particularly focusing on the springing problem. Springing is an important parameter that exerts a large tension in special cases. It is a nonlinear phenomenon and requires the 2nd-order wave loads to solve. In this paper, a new prediction method for springing and the resultant extreme tension on the tendon of a TLP is introduced. Using the 2nd-order response function computed using the commercial program WADAM, the probability density function of the 2nd-order tension is obtained from an eigenvalue analysis using a quadratic transfer function and sea spectra. A new method is then suggested to predict the extreme tension loads with respect to the number of occurrences. It is shown that the PDF suggested in this study properly predicts the extreme tension in comparison with the time histories of the 2nd-order tension. The expected tension force is larger than that from a linear analysis in the same time windows. This supports the use of the present method to predict the tension due to springing.

Dynamic Stabilization of the Scapula for Serratus Anterior Dysfunction

  • Jeong, Su-Tae;Warner, Jon J.P.
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.53-53
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    • 2008
  • Twenty-six patients (12 male and 14 female) with symptomatic scapular winging caused by serratus anterior dysfunction were managed with split pectoralis major tendon transfer (sternal head) with autogenous hamstring tendon augmentation from 1998 to 2006. Twenty-five patients had positive results for long thoracic nerve palsy on electromyography. The mean duration of symptoms until surgery was 48 months (range 12~120 months). Four patients had non-traumatic etiologies and twenty-two patients had traumatic etiologies. At the final follow-up assessment for functional improvement, a Constant-Murley score was used. 21 patients were completely evaluated, while 5 patients who had less than 12 months follow-up were excluded. Pain relief was achieved in 19 of the 21 patients, with twenty patients showing functional improvement. The pain scores improved from 6.0 preoperatively to 1.8 postoperatively. The mean active forward elevation improved from $108^{\circ}$ (range $20^{\circ}\sim165^{\circ}$) preoperatively to $151^{\circ}$ (range $125^{\circ}\sim170^{\circ}$) postoperatively. The mean Constant-Murley score improved from 57.7 (range 21~86) preoperatively to 86.9 (range 42~98) postoperatively. A recurrence developed in one patient. Of the twenty-one patients, eight had excellent results, nine had good results, three had fair results, and one had poor results. Most patients with severe symptomatic scapular winging had functional improvement and pain relief with resolution of scapular winging.

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Simultaneous reconstruction of the forearm extensor compartment tendon, soft tissue, and skin

  • Oh, Jeongseok;Ahn, Hee Chang;Lee, Kwang Hyun
    • Archives of Plastic Surgery
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    • v.45 no.5
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    • pp.479-483
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    • 2018
  • Malignant peripheral nerve sheath tumor (MPNST) is a very rare type of sarcoma, with an incidence of 0.001%. MPNST has a 5-year survival rate near 80%, so successful reconstruction techniques are important to ensure the patient's quality of life. Sarcoma of the forearm is known for its poor prognosis, which leads to wider excision, making reconstruction even more challenging due to the unique anatomical structure and delicate function of the forearm. A 44-year-old male presented with a large mass that had two aspects, measuring $9{\times}6cm$ and $7{\times}5cm$, on the dorsal aspect of the right forearm. The extensor compartment muscles (EDM, EDC, EIP, EPB, EPL, ECRB, ECRL, APL) and invaded radius were resected with the mass. Tendon transfer of the entire extensor compartment with skin defect coverage using a $24{\times}8cm$ anterolateral thigh (ALT) perforator free flap was performed. The patient was discharged after 18 days without wound complications, and has not complained of discomfort during supination, pronation, or wrist extension/flexion through 3 years of follow-up. To our knowledge, this is the first report of successful reconstruction of the entire forearm extensor compartment with ALT free flap coverage after resection of MPNST.

Reconstruction for Soft Tissue Defect of Dorsum of Hand or Foot with Free Temporal Fascial Flap (유리 측두 근막판을 이용한 수배부 및 족배부 연부조직 결손의 재건)

  • Lee, Byoung Ho;Nam, Yun Kwan;Ju, Pyong
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.37-43
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    • 2000
  • Vascularized tissue coverage is necessary for treatment of soft tissue defect with bone and tendon exposure on hand and foot dorsum, which cannot be successfully covered with simple skin graft or local flap. The temporal fascia is one of the most ideal donor for coverage of soft tissue defect of dorsum of hand or foot in term of ultra-thin, pliable and highly vascular tissue. Also, this flap offers the advantage of a well-concealed donor site in the hair-bearing scalp and smooth tendon gliding. We have experienced 11 cases of reconstruction for soft tissue defect in the hand or foot using temporal fascial flap with skin graft. All cases survived completely and we could gain satisfactory functional results. There were no specific complications except one donor site alopecia We think that the free temporal fascial flap coverage is a highly reliable method for soft tissue defect in hand and foot dorsum. However, the potential pitfalls is secondary alopecia and requirement of skin graft after its transfer.

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A Case of Combined Korean Medicine Treatment for Recurrent Limb Weakness after Guillain-Barré Syndrome Improvement: Case Report (길랑바레 증후군 호전 이후 재발한 사지무력 증상에 대한 한방 복합치료 1예: 증례보고)

  • Park, Song-Mi;Cho, Sung-Woo
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.4
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    • pp.135-142
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    • 2019
  • The objective of this study is to propose Korean Medicine treatment for recurrent limb weakness after Guillain-Barre syndrome (GBS) improvement by intraveinous immunoglobulin, and to report its effectiveness. Manual muscle test (MMT), Korean modified Bathel index (K-MBI), and tendon reflex were used to evaluate the patient. The patient was improved hip joint, knee joint, ankle joint MMT from grade 3-/3- to grade 5/5 and in the upper limb the patient can do big joint exercise but cannot do micromovement like writing or using cell phone. When discharge date the patient's wrist joint MMT grade is improved grade 5-/5- to grade 5/5. The K-MBI score is improved from 71 to 86 and there was a big change in walking and chair/bed transfer, there was no change in tendon reflex. This study suggests that Korean Medicine can be effective for patients who have recurrent limb weakness after GBS improvement.

Bilateral Digital Extensor Hypoplasia Correction: A Case Report and Systematic Review

  • Marudeen Aivaz;Esperanza Mantilla-Rivas;Ashleigh Brennan;John Thomas;Elizabeth L. Malphrus;Monica Manrique;Albert K. Oh;Gary F. Rogers
    • Archives of Plastic Surgery
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    • v.50 no.2
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    • pp.177-181
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    • 2023
  • Digital extensor hypoplasia (DEH) is a rare malformation that presents with loss of active finger extension at the metacarpophalangeal (MCP) joints. Descriptions of optimal treatment and outcomes in this population are sparse. We describe successful operative treatment of a child with DEH involving the extensor digitorum communis, extensor digiti minimi, and the extensor indicis proprius tendons. The 5-year-old male patient was referred for severe limitation on bilateral finger extension since birth. He had been previously diagnosed with arthrogryposis and managed conservatively. Due to lack of improvement, magnetic resonance imaging was done evidencing hypoplasia/aplasia of the extensor tendons. The patient underwent successful tendon transfers using extensor carpi radialis longus to the common extensor tendons, and one hand required an additional tenolysis procedure. 2 years postoperatively, his MCP position and finger extension are markedly improved, and he is able to grip objects without limitation or difficulty. The patient returned to full activity without restriction.

Measurement of Transfer Length for a Seven-Wire Strand with FBG Sensors (FBG 센서를 이용한 강연선 전달길이 측정)

  • Lee, Seong-Cheol;Choi, Song-Yi;Shin, Kyung-Joon;Kim, Jae-Min;Lee, Hwan-Woo
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.28 no.6
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    • pp.707-714
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    • 2015
  • In this paper, an experimental program has been conducted to investigate transfer length in high strength concrete members pretensioned through a seven-wire strand with FBG sensors. To measure transfer length, five members were fabricated, which had a length of 3 m and a cross-section of $150{\times}150mm$. It was measured that the concrete compressive strength was 58MPa at pretensioning. Test results indicated that more precise and reliable measurement on the transfer length was attained with FBG sensors than conventional gauges attached on concrete surface. Through comparing the measured transfer length and predictions, applicability of several transfer length models in literature was investigated. This paper can be useful for relevant research field such as investigation on the bond mechanism of a seven-wire strand in concrete members.

Bilateral Traumatic Locked Posterior Dislocation of the Shoulder - A Case Report - (외상 후 발생한 양측성의 견관절 잠긴 후방 탈구 - 증례 보고 -)

  • Lim, Jong-Min;Suh, Jeung-Tak;Ahn, Jae-Min
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.226-231
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    • 2009
  • Purpose: Bilateral traumatic locked posterior dislocations of the shoulder are very rare and there has been no report on the operative treatment for this injury in the Korean medical literature. Materials and Methods: We present here a case of bilateral locked posterior dislocations of the shoulders after trauma and this was successfully treated with open reduction and lesser tuberosity transfer on the right shoulder and subscapularis tendon transfer on the left shoulder. Results and Conclusion: Twenty-four months later, the clinical and radiologic results were excellent.

Ultimate Uplift Capacity of Permanent Anchor Embedded in Weathered Rock (풍화암에 근입된 영구 앵커의 극한인발력)

  • Yoo, Nam-Jae;Park, Byung-Soo;Jeong, Gil-Soo;Kim, Jin-Hwang
    • Journal of Industrial Technology
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    • v.21 no.B
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    • pp.195-203
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    • 2001
  • The purpose of this study is to estimate ultimate uplift capacity of permanent anchor which was cast into weathered rock. The ultimate uplift capacity was estimated from the load-displacement curve of four different anchors which have different bond length. The creep test was performed for 15minutes under the maximum load of each step in order to understand the load-transfer property of permanent anchor and to decide which anchor to choose. The destruction range of soil due to the changes in load was estimated by installing dial gauge on the ground which was cast into the weathered rock. Ultimately, the study on the behavior of the anchor case into the weathered rock was performed by comparing and analyzing the estimated result of the UUC obtained by the full scale pull out test in the field with the exsting theoretical and practical results of soil and rock anchor.

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