Anatomy of Peroneal Buoy Flap / 대한정형외과학회잡지

Authors analysed 36 cases(33 patients) of Peroneal Buoy Flap to investigate branching pattern, course, length of vascular pedicle, and perforating level of the perforating cutaneous branches from Oct. 1985 to July 1988. The results were as follows. 1. The perforating cutaneous branchea were classified into four types, the Straight Branch (18 cases), the Proximal Oblique Branch (8 cases), the Branch from Muscular Artery (8 cases), the Distal Oblique Branch(2 cases) respectively. The most common patten was Straight Branch. 2. There were 3 pathways of these branches, the most common one passed between the Soleus and Peroneus muscles(23 cases, 64%), and second one passed through the snterior part of Soleus muscle(8 cases, 22%), the third one passed through the posterior part of Peroneus muscle(5 cases, 14%). 3. The length of vascular pedicle in Buoy Flap was variable from 3cm to 15cm, but 27 cases(75%) were distributed between 4cm and 6cm. 4. The perforating level of branches were 6.3cm in average from Fibular Neck, 88% of them were distributed within 10cm. 5. Peroneal Buoy Flap in possible to reconstruct both seperated bone and skin defect in some distance by One-Stage Operation.

Free Vascularized Epiphyseal Transplantation, for Epiphyseal Injury in Children / 대한정형외과학회잡지

It is difficult to treat the children with the growing deformity of long bone due toepiphysealloss or absence, because resulting deformith and discrepancy of limb length is progressive. There were many conventional treating methods including the lengthening and shortening, corrective osteotomy, and epiphysiodesis. But these procedures result in inadequate results, and there are limitation in treatment of these children. We tried the free vascularized epiphyseal transplantation using the proximal fibular epiphysis in 3 patients with epiphyseal injury or loss due to old tauma, wide excision of multiple exostosis and congenital clubhand. The duration of follow-up was from 20 months to 57 months, and the lengthening of the transplantedepiphyses was evaluated by the scanogram inregular interval. As final radiologic check, each transplanted epiphyseal growth was 1cm for 24months in case 1, 0.9 cm for 10 months in case 2, 1 cm for 24 months in case 3 (av. 1.3cm for 24 months) and the adjacent joint function was good. There was no gross deformity.

Reconstruction of Large Bone Defect after Wids Segmental Resection of Long Bone Tumors Using the Free Vascularized Fibular Graft / 대한정형외과학회잡지

In certain low-grade malignant tumors and tumors that have a frequent recurring tendency in long bone, the wide segmental resection can cure and prevent to recur. But a main problem is prserving of bony continuity in bony defect site due to wide segmental resection. The traditional bone graft have the high incidence in non-union, malunion, delayed union, bony reabsorption, stress fracture despite long immobilization and stiffness of adjacent joint. We have attempted to overcome these problems by using a microvascular technique to transfer the fibula with its peroneal vascular pedicle as a living bone graft. From February 1980 to August 1986, we tried the reconstruction of wide bone defect after segmental resection at long bone tumors in 10 cases, using Vascularized Fibular Graft. The types of tumors were malignant fibrous histiocytoma in 2 cases, fibrous dysplasia in 2 cases, simple bone cyst in 1 case, giant cell tumor in 2 cases, cavernous hemangioma in 2 cases and multiple exostosis in 1 case. An average follow-up was 48 months, average bone defect after wide segmental resection of lesion was 12.3cm.These all cases revealed the good bony union in average 4.5 months, the free ambulation without external immobilization was got in average 6 months. And we got the wide range of motion of adjacent joint without recurrence and serious complications.

A Clinical Study of the Operative Treatment for the Spondylolisthesis / 대한정형외과학회잡지

We reviewed 35 patients who received an operation for the Spondylolisthesis from July 1980 to July 1985. The follow-up period between operation and evaluation was at least 14 months and average 32 months. we obtained the following results. 1. The age distribution was from 23 years of age to 70 years of age and the prevalent decade was at the 5th. 2. Sex difference showed male 9 cases and female 26 cases, that is, female preponderance about 3 times. 3. 24 cases were isthmic type and 11 cases were degenerative type. The ratio between isthmic type and degenerative type was about 2: l. 4. Isthmic type was found at the 4th and 5th decades frequently and degenerative type was at 5th and 6th decade frequently. 5. The displacement between L4 and L5 was 21 cases and the displacement between L5 and sacrum was 14 cases. 6. In isthmic type, the displacement between L4 and L5 was 11 cases and the displacement between L5 and sacrum was 13 cases. In degenerative type, the displacement between L4 and L5 was 10 cases and the displacement between L5 and sacrum was 1 case. So the isthmic defect occurred at 2 levels almost equally and degonerative type occurred at L4-5 predominantly. 7. Overall results are excellent 2 cases(6%), good 29 cases(82%), fair 2 cases(6%), and poor 2 cases (6%).