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- 주제어 : Distal leg (검색결과 5 건)
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이승현,이혜경,조필동,Lee, Seung-Hyun,Lee, Hye-Kyung,Cho, Pil-Dong 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.6
Purpose: Reconstruction of soft tissue defects in the distal lower leg, especially in the distal third, largely depends on free tissue transfer and local fasciocutaneous flaps. But several local muscle flaps have also been proposed as useful alternative reconstructive manner. In this report, the authors present the successful use of the flexor digitorum longus muscle flaps in the distal lower leg reconstruction. Methods: Case 1: An 81-year-old woman with a dog bite wound in the left distal lower leg was admitted. She had a $10{\times}8\;cm$ wound with tibial exposure along the medial aspect of the leg. Soft tissue reconstruction with a flexor digitorum longus muscle flap and a split-thickness skin graft was performed. Case 2: A 77-year-old woman had a squamous cell carcinoma in the right distal lower leg. After wide excision, a $5{\times}4\;cm$ wound was developed with exposure of the tibia. The flexor digitorum longus muscle flap was transposed and covered with a split-thickness skin graft. Results: The flexor digitorum longus muscle flaps were shown to be useful to cover tibial defects in the distal lower leg. During the follow-up period, no significant donor site morbidity was found. Conclusion: The flexor digitorum longus muscle flap can be used to cover the exposed distal tibia, especially when a free tissue transfer is not an option. The relative ease of dissection and minimal functional deficits were the major advantages of this flap, while the extent of reach into the lower third has a limitation.
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Posterior Calf Fasciocutaneous Flap을 이용한 하지 연부조직의 재건
안성열,임동훈,조용근 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.3
Reconstruction of soft tissue defects of the lower leg and foot continues to challenge plastic surgeons. Significant open wounds of the distal third of the lower leg that require some form of vascularized flap have historically been covered with distant random cross leg flaps, or more appropriately, with micro surgical tissue transfers. Since the clinical work of Ponten in 1981, fasciocutaneous flap has been shown that fascia has a rich vascular plexus. The axial pattern blood supply of the fasciocutaneous flap of the posterior calf was characterized by a dominant subfascial descending cutaneous branch of the popliteal artery. Besides this, the sural and the geniculate artery were composed of this flap. We used the posterior calf fasciocutanous flap in 12 cases of lower extremity reconstruction and obtained satisfactory results except one. We concluded that advantages of this flap are that it is easy to raise, reliable, versatile, and capable of harvesting a broad flap. The addition of this technique in reconstructive surgery has been a very useful in repairing soft tissue defects of lower leg.
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( Shuntaro Nejima ),( Ken Kumagai ),( Shunsuke Yamada ),( Masaichi Sotozawa ),( Yutaka Inaba ) 대한슬관절학회 2023 대한슬관절학회지 Vol.35 No.-
Background To evaluate the expected postoperative total leg length change using preoperative radiographs during surgical planning of four different methods of double level osteotomy (DLO). Methods This study included 34 patients (44 knees) who underwent DLO for varus knee osteoarthritis. Surgical planning was performed so that the postoperative weight bearing line ratio was 62.5%. In DLO, lateral closed or medial open wedge distal femoral osteotomy (LCWDFO, MOWDFO) was performed so that the postoperative mechanical lateral distal femoral angle was 85°, and residual deformity was corrected with medial open or lateral closed wedge high tibial osteotomy (MOWHTO, LCWHTO). Pre- and surgical planning X-rays in the one-leg standing position were compared to assess the change in leg length, and the factors affecting it, in the various surgical groups. The proportion of cases in which Δ total leg length was greater than 6 mm (symptomatic change) was investigated. Results The mean postoperative total leg length increased significantly with LCWDFO + MOWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, while it decreased with LCWDFO + LCWHTO. The proportion of cases with a postoperative total leg length change > 6 mm was 72.7%, 2.3%, 100%, and 6.8% in LCWDFO + MOWHTO, LCWDFO + LCWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, respectively. In addition, the preoperative hip-knee-ankle angle correlated negatively with the postoperative total leg length change in LCWDFO + MOWHTO, MOWDFO + MOWHTO, and MOWDFO + LCWHTO, but not in LCWDFO + LCWHTO. Conclusions MOWDFO + MOWHTO had the largest postoperative leg length change and MOWDFO + LCWHTO had the smallest. Symptomatic leg length change (> 6 mm) should be considered in MOWDFO + MOWHTO and LCWDFO + MOWHTO.
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경골 및 비골 원위부 골육종의 종양삽입물을 이용한 사지구제술
이한구,이상훈,김동준,Lee, Han-Koo,Lee, Sang-Hoon,Kim, Dong-Jun 대한근골격종양학회 1995 대한골관절종양학회지 Vol.1 No.1
Recently limb-salvage operation is widely used for the treatment of malignant bone tumor. But distal leg is out of range of limb-salvage operation due to its technical problem. We report satisfactory limb-salvage operation with tumor prosthesis in 3 cases of osteosarcoma of the distal tibia and fibula. Two cases involved in the tibia and 1 case in the fibula. Average age at operation was 23 years. Neoadjuvant and adjuvant chemotherapy were performed in all 3 cases. We used custom made tumor prosthesis which is designed by Seoul National University Orthopaedic Department. Overall Functional Evaluations by Enneking rating system were good in all 3 cases. All cases are CDF(continuosly disease free since the surgical procedure) state at mean follow-up 2 year and 9 months. In conclusion limb-salvage with tumor prosthesis is useful treatment modality for malignant bone tumor of distal tibia and fibula. Good functional results and few complications suggests limb salvage of distal lower leg may be replaceable with B-K amputation.
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하퇴부와 족관절 및 족부의 피부 결손에 대한 역행성 표재 비복동맥 피판을 이용한 재건의 장점
하대호,김상수,전철홍,김동철,최유선,김경진,Ha, Dae-Ho,Kim, Sang-Soo,Chun, Churl-Hong,Kim, Dong-Churl,Choi, Yu-Sun,Kim, Kyeong-Jin 대한미세수술학회 2001 Archives of reconstructive microsurgery Vol.10 No.2
Introduction : We report advantages of distally based superficial sural artery flap in the soft tissue defect in lower leg, ankle and foot. They are easier and less complicated technique than others. Material & Method : Total 26 patients were operated and their soft tissue defect site were 10 cases of anterior tibial surface, 6 cases of Achilles tendon area, 3 cases of lateral and medial surface of tibia, 3 cases of foot dorsum surface, 3 cases of sole, 1 case of medial aspect of ankle. Average pedicle distance was 12.8 cm(range $8{\sim}21cm$) and follow up period was mean 18 months. Result : We obtained 24 cases of excellent and good results. The two cases were reported low complication rate, which were one case of skin necrosis covered full thickness skin graft, and the other case of infection. Conclusion : The advantage of distally based superficial sural artery flap in soft tissue defect are long distant pedicle, short operation time, easy elevation of pedicle, constant and reliable blood supply and good cosmetic result with thin-thickness flap.
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