• Journal of Trauma and Injury
• /
• v.36 no.1
• /
• pp.60-64
• /
• 2023

Upper extremity vascular injuries occurring with acute compartment syndrome are very challenging to manage in an emergency context in resource-poor settings. The need to always recognize the likelihood of coexisting compartment syndrome guides surgeons to perform concomitant fasciotomy to ensure a better outcome. We managed three vascular injuries in the upper extremities in two patients with concomitant imminent compartment syndrome observed intraoperatively. The first injury was complete brachial artery disruption following blunt trauma, while the second and third injuries were radial and ulnar artery transection caused by sharp glass cuts. Both patients were treated with vascular repair and fasciotomy. Secondary wound coverage was applied with split-thickness skin grafting, and the outcomes were satisfactory. Concomitant fasciotomy potentially improves the outcomes of vascular repair in emergency vascular surgery and should be considered for all injuries with the potential for acute compartment syndrome.

• Child Health Nursing Research
• /
• v.4 no.1
• /
• pp.17-30
• /
• 1998

In order to investigate the effects of a decreased activity on skinfold thickness, circumference and muscle strength of the extremities during the recovery period following heart surgery, skinfold thickness, circumference and muscle strength of the extremities were measured on days 0, 3, 6, and 9 following the surgery, and compared with those on the arrival day of intensive care unit. Skinfold thickness was measured using a skinfold caliper(Saehan Cor., Korea), circumference of the limbs were measured with a tape measure, upper extremity strength was determined using the Takei grip dynamometer and lower extremity strength was measured by pressing the flatfoot on an electronic digital health meter while tying on a bed. Results from this study were thus : 1. Skinfold thickness of triceps, quadriceps and gastrocnemius muscle on days 3, 6, 9 following the heart surgery was not significantly different from that of on the day of operation. 2. Circumference of midupperarm and midthigh on days 3, 6, 9 following the heart surgery was not significantly different from that of on the day of operation. Circumference of midcalf on days 3, 6 following the heart surgery was not significantly different from that of on the day of operation, while that of midcalf on day 9 following the surgery decreased significantly compared with that of on the day of operation. 3. Muscle strength of the upper extremity was not significantly different from that of on the day of operation, while that of the lower extremity on day 9 following the surgery decreased significantly compared with that of on the day of operation. From these results, it may be concluded that circumference and muscle strength of lower extremity can be decreased due to the postoperative inactivity following heart surgery in congenital heart disease children.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.22 no.1
• /
• pp.71-76
• /
• 2016

Background: The objective of this research is to provide base line data on Korea Baseball rehabilitation treatment by presenting the distribution of upper extremity surgeries according the surgical sites of Korean professional baseball players. Methods: The targets of this research are 561 players from nine Korean baseball clubs. The number of players that have undergone surgery was investigated. In other words, the frequency of shoulder joint surgeries, elbow joint surgeries, and wrist and hand surgeries per each baseball club was investigated. Results: The number of the players who have had surgeries was 151, but among the players, there were some who have had repeated surgeries for which the total number of surgery experience was 162. The result showed that elbow joint surgeries were the most frequently enacted, followed by shoulder joint surgeries, and wrist and hand surgeries. From the nine clubs, Samsung was the club with the highest frequency of surgeries. Conclusions: This research shows that Korean professional baseball players need special training centers with systematic rehabilitation programs. Another conclusion suggests that urgent need for rehabilitation program of upper arm which particularly focused on elbow joint is existing. On the basis of this research, we expect more studies on the specific rehabilitation programs which is categorized by injury areas.

• Journal of the Korean Burn Society
• /
• v.24 no.2
• /
• pp.68-73
• /
• 2021

Purpose: A large defect by fourth-degree burns in the upper limb requires flap reconstruction. Since severe vascular damage and decrease in blood circulation after vascular anastomosis can occur in defects caused by fourth-degree burns. Because of the disadvantages, it is difficult to apply free flap surgery to fourth-degree burns. We reconstructed a upper extremity using the pedicled Latissimus Dorsi (LD) flap in two stages. The purpose of our study is to review our experience and suggest two-staged pedicled Latissimus Dorsi (LD) flap in fourth-degree burns of upper extremities. Methods: A retrospective review was performed from 2016 to 2019, on a total of 12 fourth-degree burn patients undergone two-staged pedicled LD flap surgery as reconstruction of upper extremities in our hospital. We reviewed the location of the injury, etiology, TBSA (%), size of burns requiring flap surgery, period from 1st surgery to secondary division surgery, complications. Results: Using two-staged LD flap as a primary reconstruction, the outcome is satisfactory. This flap preserves the elbow joint and maintains the length of the forearm. We obtain low donor-site morbidity, simplicity and a small incision in the donor site. Conclusion: Using two-staged LD flap in fourth-degree burns of upper extremity is effective, such as preserving elbow joint and maintaining the length of the forearm. Successful reconstruction was achieved with excellent cosmetic results with reducing a postoperative scar, donor-site morbidity. Due to these advantages, two-staged pedicled LD flap can be an optimal option for reconstruction of fourth-degree burns in the upper limb.

• Archives of Reconstructive Microsurgery
• /
• v.18 no.1
• /
• pp.1-8
• /
• 2009

Purpose: The perforator flaps have established their role in the reconstruction of various soft tissue defects. For the last five years, we have extensively used anterolateral thigh (ALT) flap for the reconstruction of the complex tissue defects of the hand and upper extremity and report the clinical results and our experiences with the versatile applications of this flap. Materials and Methods: From March 2003 through May 2008, 119 free ALT perforator flaps were transferred for reconstruction of the complex tissue defects of the elbow, forearm, wrist and hand after crushing or degloving injuries as well as severe scar contractures. There were 95 females and 24 males. The mean age of the patients was 37 years and mean size of the flap was 170 $cm^2$. In 20 cases, the flap was vascularized by septocutaneous and in 99 cases by musculocutaneous perforators. Intra-muscular dissection length averaged 3.4 cm. The total length of pedicle averaged 8.4 cm and the average arterial diameter was 0.84 mm. End-to-end arterial anastomosis was performed in 103 cases and end-to-side in 16 cases. Results: Flap survival rate was 98.3%(117/119) and there were 6 cases of partial necrosis. Donor site was closed primarily in 41 cases and skin grafts were applied in 78 cases. Conclusion: The reliability and versatility of ALT flap makes it one of the foremost choices for the reconstruction of complex tissue defects of the upper extremity.

• Journal of the Korean Society of Physical Medicine
• /
• v.2 no.1
• /
• pp.11-20
• /
• 2007

Purpose : The purpose of this study was to evaluate effects of shoulder girdle stability exercise on upper extremity muscle strength. Methods : Subjects were consist of 20 people who had no disorder of upper extremity from 20 to 27 years of age during 6 weeks from April 3, 2006 to May 14. Ten of all subjects exercised muscles which stabilize to shoulder girdle for 30 minutes during 6 weeks. Biodex was used to measure upper extremity muscle strength. Results : There are increasing of shoulder flexion and extension on average torque but no statistically significant difference between pre-exercise and post-exercise. Conclusion : There are no severe difference between exercise group and non-exercise group on muscle strength.

• Archives of Plastic Surgery
• /
• v.44 no.6
• /
• pp.564-566
• /
• 2017

• Archives of Plastic Surgery
• /
• v.36 no.6
• /
• pp.707-713
• /
• 2009

Purpose: The deep inferior epigastric perforator(DIEP) free flap is well known as an ideal donor site for the breast reconstruction. The flap can provide huge amount of fat tissue for breast and buttock contour, while it is also very useful as a thin skin flap to reconstruct the upper and lower extremities. We used a DIEP free flap in various site reconstructions besides the breast and would like to reinsure the usefulness of this flap. Methods: Twenty nine consecutive patients who underwent DIEP free flap surgery from 2001 January to 2007 December were reviewed. The case constituted seven male patients and twenty two female patients. There were sixteen breast reconstructions, five face reconstructions, five lower extremity reconstructions, two upper extremity reconstructions, and one buttock contour reconstruction. All clinical data were based on the patient's medical records. Results: All DIEP free flaps survived without major complications. There was no hematoma, seroma, or partial necrosis. The donor sites were closed primarily with linear scar on lower abdomen. The thinnest part of flap was 0.7 cm in thickness. The size of the largest flap was $38{\times}13cm$. The flaps were used in various types of skin and adipose tissue, adipose tissue only, and skin only according to the requirement of recipient site. Conclusion: The DIEP free flap was enough to provide a thin and huge flap for both breast and extremity reconstructions. It was able to provide versatile designs with sufficient adipose tissue. So we use it for 3 - dimentional face and buttock contour reconstructions. The DIEP free flap is a valuable reconstructive donor for face, upper and lower extremity in addition to breast without compromising the integrity of abdominal wall.

• 대한미세수술학회:학술대회논문집
• /
• 2001.11a
• /
• pp.194-196
• /
• 2001

• The Korean Journal of Pain
• /
• v.24 no.3
• /
• pp.158-163
• /
• 2011

Background: Although a brachial plexus block can be used to provide anesthesia and analgesia for upper extremity surgery, its effects using $MgSO_4$ on postoperative pain management have not been reported. The aim of this study was to evaluate brachial plexus block using $MgSO_4$ on postoperative analgesia. Methods: Thirty-eight patients who were scheduled to undergo upper extremity surgery were randomly allocated into two groups: patients receiving axillary brachial plexus block with 0.2% ropivacaine 20 ml and normal saline 2 ml (group S) or 0.2% ropivacaine 20 ml and $MgSO_4$ 200 mg (group M). Before extubation, the blocks were done and patient controlled analgesia was started, and then, the patients were transported to a postanesthetic care unit. The postoperative visual analogue scale (VAS), opioid consumption, and side effects were recorded. Results: The two groups were similar regarding the demographic variables and the duration of the surgery. No differences in VAS scores were observed between the two groups. There was no statistically significant difference in opioid consumption between the two groups. Nausea was observed in three patients for each group. Conclusions: Axillary brachial plexus block using $MgSO_4$ did not reduce the level of postoperative pain and opioid consumption.