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앞가쪽 넙다리 유리 피판 공여부위 기능의 객관적인 평가
- Alternative Title
- Han Dae Hee
- Author(s)
- Han, Dae Hee
- Alternative Author(s)
- Han Dae Hee
- Advisor
- 박명철
- Department
- 일반대학원 의학과
- Publisher
- The Graduate School, Ajou University
- Publication Year
- 2014-02
- Language
- eng
- Alternative Abstract
- The anterolateral thigh flap (ALT) is based on the perforators of the descending branch of the lateral circumflex femoral artery. As there are several anatomical variations of the lateral circumflex arterial system, muscle dissection is unavoidable when skin perforator vessels run through the vastus lateralis muscle. In the present study, we prospectively evaluated donor extremity function and investigated the objective functional morbidity of the donor site. We performed a prospective study on 14 cases of head and neck defect reconstruction using free ALT flap at Ajou university hospital between September 2011 and November 2012. Patients were followed-up postoperatively at 6 months by questionnaire. The Biodex System (Biodex medical systems, providing reliable and reproducible data, was used for the dynamic functional evaluation of the knee joint of patients both preoperatively and postoperatively. We compared the variables pre-operation and post-operation and in terms of the donor limb and non-donor limb, septocutaneous perforator and musculocutaneous perforator, donor site primary closure and skin graft, and size of flap <64cm2 vs. ≥64cm2. All flaps survived and the recovery of the donor limb was uneventful. On postoperative follow up, some patients complained their decreased sensation around the donor limb and decreased mobility. However, there was no limitation in their daily life. In the objective test, overall, there were no significant differences between the groups, except for total work at 180° extension (0.0459). Changes in the ratio of peak torque/weight and total work of the knee extension or flexion were statistically negligible (p<0.05). The results of our questionnaire mirrored the literature. Pain and hypoesthesia were observed, but, they did not interfere with their daily life. There was decrease in total work of knee extension compare to the preoperative data. The postoperative long period of rest may cause delayed functional recovery. Therefore, we have to encourage the patient to do the rehabilitation exercise. The present study indicates that functional damage to the donor limb of the anterolateral thigh flap is minimal even if the muscle is injured during harvesting. Moreover, we found that complaints concerning a decreased mobility were not objective from the results of our questionnaire.
- Fulltext
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- Graduate School of Ajou University > Department of Medicine > 3. Theses(Master)
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