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  • Roh, Si Young  (26)
  • 2020-2024  (26)
  • 1
    Online-Ressource
    Online-Ressource
    Arterial or venous free flaps for volar tissue defects of the proximal interphalangeal joint: A comparison of surgical outcomes
    Georg Thieme Verlag KG ; 2020
    In:  Archives of Plastic Surgery Vol. 47, No. 5 ( 2020-09-15), p. 451-459
    Details
    In: Archives of Plastic Surgery, Georg Thieme Verlag KG, Vol. 47, No. 5 ( 2020-09-15), p. 451-459
    Kurzfassung: Background For volar soft tissue defects of the proximal interphalangeal (PIP) joint, free flaps are technically challenging, but have more esthetic and functional advantages than local or distant flaps. In this study, we compared the long-term surgical outcomes of arterial (hypothenar, thenar, or second toe plantar) and venous free flaps for volar defects of the PIP joint.Methods This was a single-center retrospective review of free flap coverage of volar defects between the distal interphalangeal and metacarpophalangeal joint from July 2010 to August 2019. Patients with severe crush injuries (degloving, tendon or bone defects, or comminuted/intra-articular fractures), thumb injuries, multiple-joint and finger injuries, dorsal soft tissue defects, and defects 〉 6 cm in length were excluded from the study, as were those lost to follow-up within 6 months. Thirteen patients received arterial (hypothenar, thenar, or second toe plantar) free flaps and 12 received venous free flaps. Patients’ age, follow-up period, PIP joint active range of motion (ROM), extension lag, grip-strength ratio of the injured to the uninjured hand, and Quick Disabilities of Arm, Shoulder & Hand (QuickDASH) score were compared between the groups.Results Arterial free flaps showed significantly higher PIP joint active ROM (P=0.043) and lower extension lag (P=0.035) than venous free flaps. The differences in flexion, grip strength, and QuickDASH scores were not statistically significant.Conclusions The surgical outcomes of arterial free flaps were superior to those of venous free flaps for volar defects of the PIP joint.
    Materialart: Online-Ressource
    ISSN: 2234-6163 , 2234-6171
    URL: Article
    DOI: 10.5999/aps.2020.00269
    Sprache: Englisch
    Verlag: Georg Thieme Verlag KG
    Publikationsdatum: 2020
    ZDB Id: 2694943-X
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    Online-Ressource
    Online-Ressource
    Partial second toe pulp free flaps in early childhood
    Georg Thieme Verlag KG ; 2020
    In:  Archives of Plastic Surgery Vol. 47, No. 06 ( 2020-11), p. 590-596
    Details
    In: Archives of Plastic Surgery, Georg Thieme Verlag KG, Vol. 47, No. 06 ( 2020-11), p. 590-596
    Kurzfassung: Background The introduction of the partial second toe pulp free flap has enabled superior aesthetic and functional results for fingertip reconstruction in adults. Children undergoing fingertip amputation for various reasons have limited options for reconstruction. Conventional treatment could shorten the finger, leading to poor cosmesis and function. We report 18 years of our experiences with fingertip reconstruction using partial second toe pulp free flaps in patients in early childhood. Methods Medical charts of children who had undergone fingertip reconstruction using partial second toe pulp free flaps from 2001 to 2018 were retrospectively reviewed. The surgical procedures were identical to those for adults, except for the usage of 11-0 nylon sutures. Patients’ demographic data, vessel size, flap dimensions, length of the distal phalanx, and functional outcomes over the course of long-term follow-up were documented. The statistical analysis was performed with the Student t-test, the Mann-Whitney U test, and Pearson correlation analysis. Results Eighteen toe pulp flaps in 17 patients (mean age, 3.0 years) were identified. All the flaps survived without any major complications. In long-term follow-up, the flap-covered distal phalanges showed growth in line with regular development. There was no donor-site morbidity, and all children adapted to daily life without any problems. In two-point discrimination tests, the fingertip sensation recovered to almost the same level as that in the contralateral finger. Conclusions Partial second toe pulp free flaps are an excellent option for fingertip reconstruction in young children, as well as in adults.
    Materialart: Online-Ressource
    ISSN: 2234-6163 , 2234-6171
    URL: Article
    DOI: 10.5999/aps.2020.01137
    Sprache: Englisch
    Verlag: Georg Thieme Verlag KG
    Publikationsdatum: 2020
    ZDB Id: 2694943-X
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    Online-Ressource
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    Division of a single free flap in multiple digit reconstruction
    Georg Thieme Verlag KG ; 2022
    In:  Archives of Plastic Surgery Vol. 49, No. 01 ( 2022-01), p. 61-69
    Details
    In: Archives of Plastic Surgery, Georg Thieme Verlag KG, Vol. 49, No. 01 ( 2022-01), p. 61-69
    Kurzfassung: Background Single free flaps are a commonly used reconstructive method for multiple soft tissue defects in digits. We analyzed the flap size, division timing, and degree of necrosis in cases with various types of flap division. Methods We conducted a retrospective review of the medical charts of patients who had undergone single free flap reconstruction for multiple soft tissue defects across their digits from 2011 to 2020. The flap types included were the lateral arm free flap, venous forearm free flap, thenar free flap, hypothenar free flap, anterolateral thigh free flap, medial plantar free flap, and second toe pulp free flap. Flap size, anastomosed vessels, division timing, and occurrence of flap necrosis were retrospectively investigated and then analyzed using the t-test. Results In total, 75 patients were included in the analysis. The success rate of the free flaps was 97.3%. All flaps were successfully divided after at least 17 days, with a mean of 47.17 days (range, 17–243 days) for large flaps and 42.81 days (range, 20–130 days) for the medium and small flaps (P=0.596). The mean area of flap necrosis was 2.38% in the large flaps and 2.58% in the medium and small flaps (P=0.935). Severe necrosis of the divided flap developed in two patients who had undergone flap division at week 6 and week 34. Conclusions In cases where blood flow to the flap has been stable for more than 3 weeks, flap division can be safely attempted regardless of the flap size.
    Materialart: Online-Ressource
    ISSN: 2234-6163 , 2234-6171
    URL: Article
    DOI: 10.5999/aps.2021.01466
    Sprache: Englisch
    Verlag: Georg Thieme Verlag KG
    Publikationsdatum: 2022
    ZDB Id: 2694943-X
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
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    Fingertip reconstruction with a subcutaneous flap and composite graft composed of nail bed and volar pulp skin
    Georg Thieme Verlag KG ; 2022
    In:  Archives of Plastic Surgery Vol. 49, No. 01 ( 2022-01), p. 70-75
    Details
    In: Archives of Plastic Surgery, Georg Thieme Verlag KG, Vol. 49, No. 01 ( 2022-01), p. 70-75
    Kurzfassung: Background Fingertip injuries are very common; however, the reconstruction of volar pulp defects with nail bed defects is challenging in the absence of the amputated segment. We reconstructed fingertip amputations with nail bed defects using a new surgical approach: a subcutaneous flap and composite graft. Methods We treated 10 fingertip amputation patients without an amputated segment, with exposed distal phalangeal bone and full-thickness nail bed defects between February 2018 and December 2020. All patients underwent two-stage surgery: in the first stage, a subcutaneous flap was performed to cover the exposed distal phalanx, and in the second stage, a composite graft, consisting of nail bed, hyponychium, and volar pulp skin, was applied over the subcutaneous flap. Results All flaps survived and all composite grafts were successful. The wounds healed without any significant complications, including the donor site. The average follow-up duration was 11.2 months (range, 3–27 months). The new nail and the shape of the volar pulp were evaluated during follow-up. All patients were satisfied with their natural fingertip shapes and the new nails did not have any serious deformities. Conclusions A subcutaneous flap in combination with a composite graft fitting the shape of the defect could be another option for fingertip injuries without amputated segments.
    Materialart: Online-Ressource
    ISSN: 2234-6163 , 2234-6171
    URL: Article
    DOI: 10.5999/aps.2021.01200
    Sprache: Englisch
    Verlag: Georg Thieme Verlag KG
    Publikationsdatum: 2022
    ZDB Id: 2694943-X
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 5
    Online-Ressource
    Online-Ressource
    Usefulness of Color Doppler Ultrasonography for the Preoperative Evaluation of Thin Anterolateral Thigh Flap Perforators
    Korean Society for Surgery of the Hand ; 2021
    In:  Archives of Hand and Microsurgery Vol. 26, No. 4 ( 2021-12-01), p. 270-275
    Details
    In: Archives of Hand and Microsurgery, Korean Society for Surgery of the Hand, Vol. 26, No. 4 ( 2021-12-01), p. 270-275
    Kurzfassung: Purpose: The anterolateral thigh flap is commonly applied to various body sites for reconstruction. However, surgeons often struggle against unexpected locations and the nature of perforator vessels during surgery. Thus, this study aimed to assess the accuracy and usefulness of color Doppler ultrasonography as a preoperative tool for the perforator position and course of anterolateral thigh flaps.Methods: A prospective study involving 77 anterolateral thigh flaps was conducted between March 2016 and February 2021. Among them, 37 perforators (group A) were detected using the preoperative color Doppler ultrasound, and the other 40 perforators (group B) were tested using a hand-held Doppler only. All patients in group A underwent color Doppler ultrasonography performed by a radiologist at our institution. The nature and course of the perforator vessels were recorded, and their precise locations were plotted in an orthonormal coordinate system.Results: A total of 37 anterolateral thigh perforator flaps (group A) were successfully dissected. The median distance between the preoperative color Doppler ultrasonography and the real location during surgery of the perforators was 7.50 mm, which was statistically smaller than 10 mm (p 〈 0.001). This preoperative ultrasound test also had a success rate of 94.6% to determine the nature of the perforators (musculocutaneous type vs. septocutaneous type).Conclusion: Preoperative color Doppler ultrasonography provides a harmless, reliable, and accurate technique for visualizing the vascular anatomy of anterolateral thigh flaps. It has a high correlation with surgical findings, allowing surgeons to cope with variable vascular anatomy.
    Materialart: Online-Ressource
    ISSN: 2586-3290 , 2586-3533
    URL: Article
    DOI: 10.12790/ahm.21.0105
    Sprache: Englisch
    Verlag: Korean Society for Surgery of the Hand
    Publikationsdatum: 2021
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
    Online-Ressource
    Online-Ressource
    Comparison of Results Based on the Number of Kirschner Wires of Different Diameters in Antegrade Intramedullary Fixation of Fifth Metacarpal Neck Fractures
    Korean Society for Surgery of the Hand ; 2021
    In:  Archives of Hand and Microsurgery Vol. 26, No. 4 ( 2021-12-01), p. 231-237
    Details
    In: Archives of Hand and Microsurgery, Korean Society for Surgery of the Hand, Vol. 26, No. 4 ( 2021-12-01), p. 231-237
    Kurzfassung: Purpose: The purpose of this study was to compare the clinical and radiological results of patients with fifth metacarpal neck fractures using different sizes and numbers of Kirschner wires (K-wire).Methods: A single institutional retrospective review identified 67 patients with a fifth metacarpal neck fracture between January 2015 and July 2020. The minimum follow-up time was 6 months and they were all treated within 6.4 days of the initial injury. Either one K-wire (1.6 mm), two K-wires (1.1 mm), or three K-wires (0.9 mm) was used. We analyzed the bone union period, and K-wire removal period, duration of surgery, total active motion, intramedullary diameter, pre/postoperative shortening, and pre/postoperative angulation clinically. We used a Method of Shortening Stipulated to measure shortening and the Medullary Canal-lateral view method for angulation. The intramedullary diameter was measured in the mid-shaft of the fifth metacarpal bone in the coronal view. Total active motion was measured at the time of follow-up in our outpatient department.Results: Clinical and radiological parameters showed no statistically significant differences. Even though it did not present a statistical significance, the absolute mean duration of surgery was the shortest in a single K-wire group. Conclusion: The clinical and radiological outcomes of surgery were comparable regardless of the number of K-wires inserted. However, we could look forward to gaining potential benefit from shortened operation time in a single K-wire group. Since stable fixation can be obtained even if one K-wire is used, inserting one thick K-wire into the intramedullary canal can be an alternative according to the surgeon’s preference.
    Materialart: Online-Ressource
    ISSN: 2586-3290 , 2586-3533
    URL: Article
    DOI: 10.12790/ahm.21.0127
    Sprache: Englisch
    Verlag: Korean Society for Surgery of the Hand
    Publikationsdatum: 2021
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 7
    Online-Ressource
    Online-Ressource
    Fingertip Reconstruction with Subcutaneous Island Flap and Composite Graft: A Case Report
    Korean Society for Surgery of the Hand ; 2020
    In:  Archives of Hand and Microsurgery Vol. 25, No. 4 ( 2020-12-01), p. 282-286
    Details
    In: Archives of Hand and Microsurgery, Korean Society for Surgery of the Hand, Vol. 25, No. 4 ( 2020-12-01), p. 282-286
    Kurzfassung: Reconstruction of amputated fingertips is extremely challenging when the amputee is very small and severely crushed. Moreover, there are not many options if distal phalanx is exposed due to defects of soft tissue. We report a case of successful fingertip reconstruction in a 10-month-old girl using a subcutaneous island flap with a composite graft. Her fingertip of the right little finger was amputated stuck by the air purifier. Some soft tissue was lost from the stump and the bone was exposed. There was a very small amputee, and soft tissue was extremely little inside. Replantation was not possible because of the soft tissue defect. The composite graft was inadequate due to the exposure of distal phalanx and defect of soft tissue. Soft tissue island flap based terminal branch of the digital artery was transposed to cover the distal phalanx. After then, the amputee was grafted over the flap. After debridement, most of the soft tissue survived and 0.2×0.2 cm of skin defect was found, which was healed through secondary intention.
    Materialart: Online-Ressource
    ISSN: 2586-3290 , 2586-3533
    URL: Article
    DOI: 10.12790/ahm.20.0047
    Sprache: Englisch
    Verlag: Korean Society for Surgery of the Hand
    Publikationsdatum: 2020
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
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    Comparison of fasciocutaneous and fascial anterolateral thigh free flaps in foot reconstruction
    Korean Society for Surgery of the Hand ; 2023
    In:  Archives of Hand and Microsurgery Vol. 28, No. 2 ( 2023-06-01), p. 97-105
    Details
    In: Archives of Hand and Microsurgery, Korean Society for Surgery of the Hand, Vol. 28, No. 2 ( 2023-06-01), p. 97-105
    Kurzfassung: Purpose: This study compared the surgical outcomes and quality of life of patients who underwent fasciocutaneous and fascial anterolateral thigh (ALT) free flaps for the reconstruction of traumatic soft tissue defects in the foot.Methods: A single-institution retrospective review of medical data from 2008 to 2021 was conducted on 20 patients who underwent a fasciocutaneous ALT free flap or fascial ALT free flap in the foot. Information was collected on patients’ baseline information, preoperative characteristics, and postoperative courses. Quality of life was measured through the Foot and Ankle Disability Index (FADI) score. A questionnaire survey was administered to evaluate aesthetic satisfaction and subjective improvement of dryness and sensory function at the surgical site.Results: The mean flap dimensions were 13.96×4.58 cm and 10.75×3.50 cm in the fasciocutaneous and fascial groups, respectively. The overall flap failure and complication rates were higher in the fasciocutaneous group (total necrosis in one case, partial flap loss in two cases, and vascular complications in three cases). While aesthetic satisfaction and functional outcomes (FADI Sports) showed better outcomes in the fascial group, subjective improvement of dryness and sensory recovery showed better results in the fasciocutaneous group.Conclusion: In comparison to fasciocutaneous flaps, fascial free flaps demonstrated lower rates of wound complications, higher aesthetic satisfaction, and better functional outcomes, but less improvement in dryness and sensory recovery at the flap site. Therefore, the choice of a flap for foot reconstruction should depend on the plastic surgeon’s discretion and a thorough discussion with the patient.
    Materialart: Online-Ressource
    ISSN: 2586-3290 , 2586-3533
    URL: Article
    DOI: 10.12790/ahm.23.0004
    Sprache: Englisch
    Verlag: Korean Society for Surgery of the Hand
    Publikationsdatum: 2023
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
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    Single or double Kirschner wire fixation: which provides better outcomes for pediatric proximal phalanx base fractures?
    Medical Journals Sweden AB ; 2023
    In:  Journal of Plastic Surgery and Hand Surgery Vol. 58 ( 2023-09-01), p. 82-88
    Details
    In: Journal of Plastic Surgery and Hand Surgery, Medical Journals Sweden AB, Vol. 58 ( 2023-09-01), p. 82-88
    Kurzfassung: Purpose: The most common hand fracture in children is seen at the base of the proximal phalanx. This study aims to compare clinical outcomes of single versus double Kirschner wire pinning for pediatric proximal phalanx base fractures.Patients and Methods: The retrospective study enrolled patients who underwent closed K-wire pinning for proximal phalanx base fractures from January 2016 to February 2022. We divided patients into two groups based on the number of K-wire inserted (single versus double). Demographics, removal of implant, complication rate were analyzed. Patients were asked to answer the Michigan Hand Outcomes Questionnaire (MHQ) by telephone. Data including fracture type, diaphyseal axis-metacarpal head angle (DHA) and Total Active Flexion Scale (TAFS) were analyzed.Results: This study included 37 pediatric patients with proximal phalanx base fractures, treated with either single (n = 10) or double K-wire (n = 27) fixation. The mean operation time was significantly shorter for the single K-wire group. No significant differences were observed in complication rates, TAFS, implant removal times, MHQ, or pre- and post-operative DHA between the two groups. Conclusion: The single K-wire technique demonstrates similar effectiveness to the double K-wire technique in treating pediatric proximal phalanx base fractures, with the added benefit of shorter operation time. Therefore, the choice between using one or two K-wires should be determined based on the surgeon’s proficiency and preference.
    Materialart: Online-Ressource
    ISSN: 2000-6764
    URL: Article
    DOI: 10.2340/jphs.v58.13425
    Sprache: Unbekannt
    Verlag: Medical Journals Sweden AB
    Publikationsdatum: 2023
    ZDB Id: 2551921-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
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    Fingertip Necrosis due to Chemical Burn from Glacial Acetic Acid: A Case Report
    Korean Wound Management Society ; 2021
    In:  Journal of Wound Management and Research Vol. 17, No. 3 ( 2021-10-31), p. 198-201
    Details
    In: Journal of Wound Management and Research, Korean Wound Management Society, Vol. 17, No. 3 ( 2021-10-31), p. 198-201
    Kurzfassung: Glacial acetic acid is a high-purity acetic acid that is mainly used as a solvent in chemical production and for various purposes in the food and pharmaceutical industries. It is safe enough to be used for chemical peeling when diluted, and has been used in folk remedies for warts, athlete’s foot, and eczema. Indeed, such conditions are the most common reason for exposure to glacial acetic acid. In the present report, we describe the case of a 10-year-old girl who presented with pain and necrosis of the distal phalanx of her left index finger. Two days prior, her fingers had been wrapped overnight with a paste of flour mixed with glacial acetic acid to treat warts. We irrigated the affected area with normal saline, applied a mupirocin ointment, and administered prostaglandin E1. However, the necrosis progressed rapidly. After 10 days, the girl’s fingertip was amputated, and a hypothenar free flap was performed. The case represents a severe chemical burn resulting from the misuse of glacial acetic acid, requiring surgical treatment.
    Materialart: Online-Ressource
    ISSN: 2586-0402 , 2586-0410
    URL: Article
    DOI: 10.22467/jwmr.2021.01781
    Sprache: Englisch
    Verlag: Korean Wound Management Society
    Publikationsdatum: 2021
    Standort Signatur Einschränkungen Verfügbarkeit
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