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Biomedical subjects

L K Hung

Publications and source records attributed to L K Hung.

At least 55 records · Page 3Linked to original sources
PubMed1994

Congenital pseudarthrosis of the tibia in adults treated by a free vascularized iliac crest graft.

Congenital pseudarthrosis of the tibia is a rare condition. It usually presents during early childhood, at which time the surgeon is faced with numerous challenges including difficulties in achieving union and preventing refractures and recurrences. Patients frequently end up with a severe deformity or an amputation. When an adult patient presents with previously untreated congenital pseudarthrosis of the tibia, the surgeon is faced with the additional problems of a long-standing soft tissue contracture and disuse atrophy of the limb. Two patients with congenital pseudarthrosis of the tibia were treated by free vascularized iliac crest graft. Soft tissue deformity was corrected using an external fixation device. The patients were not freely ambulatory before surgery. Union across the pseudarthrosis was achieved in both patients with a double-staged operation, within a short period of time. A functional stable painless limb with good knee and ankle motion has allowed both patients to resume bipedal gait and achieve a successful rehabilitation.

Adult↗
PubMed1994

Congenital pseudarthrosis of the ulna.

Congenital ulnar pseudarthrosis is a very rare condition. Two cases are reported in addition to 36 already reported in the English literature. One of the cases reported had a "one-bone forearm" procedure done, with a satisfactory result after 6 years. The second case had a free vascularized fibula graft procedure with restoration of the bony alignment and union after 8 months of follow-up.

Bone Transplantation↗
PubMed1993

Response of fingertip circulation to local warming in the injured hand--a study using laser Doppler flowmetry.

A laser Doppler flowmeter was used to assess the fingertip circulation serially in 41 patients with various hand injuries. The "flux value" measures the flow of red cells across the site of assessment and the "fluctuation" represents the pulsatile peak-trough difference in flux value with each cardiac contraction. Local temperature at the fingertip was raised stepwise by a special heater-thermostat from 36 to 44 degrees C. Compared to the normal hand both the flux value and fluctuation in the injured hand are smaller at lower temperatures. The differences narrow down at higher temperatures and the trend reverses above 42 degrees C and remains so on cooling. This may represent abnormal sympathetic tone in the injured hand.

Adolescent↗
PubMed1993

Partial patellectomy for patellar fracture: tension band wiring and early mobilization.

Partial patellectomy for patellar fracture was performed in 56 patients. The patellar tendon-to-bone repair was reinforced by a figure-of-eight tension band wire loop from the patella down to the tibial tubercle. Early mobilization and weight bearing of the injured extremity was initiated within the first postoperative week. Thirty-one patients treated between 1977 and 1980 were reviewed retrospectively at an average of 22 months (range 3-49 months). Twenty-five patients treated between 1984 and 1987 were studied prospectively: Knee function was monitored at 5.5 weeks after injury, at 3 months, and at final follow-up at a mean of 25 months (range 8-48 months). Satisfactory knee function was recovered by 3 months. No disruption of knee extensor mechanism was encountered. Complications were frequent in the retrospective series. A high percentage of patients had radiological osteoarthritis after the fracture. This could be due to alteration of the patellofemoral articulation after part of the patella was excised.

Adolescent↗
PubMed1990

Early controlled active mobilization with dynamic splintage for treatment of extensor tendon injuries.

Early controlled active mobilization with a dynamic splint for treatment of repaired extensor tendon injuries was studied prospectively. Postoperative dynamic splintage started on the third postoperative day and involved elastic band extension and active flexion of the digits. Mobilization of the digits within the splint was done immediately under supervision. Range of motion was stepped up progressively and splintage was stopped after 5 to 6 weeks. Thirty-eight patients with 48 digits were reviewed. The average follow-up was 6.7 months (range, 4 to 10 months). Injuries involving the fingers showed an average final total active motion of 229 degrees (range, 95 to 270 degrees), whereas injuries involving the thumb was 118 degrees (range, 78 to 150 degrees). Lesions distal to the knuckles (zones II, III, IV) showed the worst results with an average total active motion of only 188 degrees (range, 95 to 270 degrees). The duration out of work was 8.5 weeks (range, 4 to 25 weeks). There was no infection or acute tendon rupture. One patient required reconstruction of a persistent button-hole deformity; two required tenolysis and capsulotomy. Of the six unsatisfactory results with poor total active motion, four had injuries distal to the metacarpophalangeal joint, three of which were crushing injuries.

Adolescent↗
PubMed1990

Vascular anatomy of the pronator quadratus muscle-bone flap: a justification for its use with a distally based blood supply.

The vascular anatomy of the pronator quadratus muscle and distal radius was studied in 24 cadaveric forearms by dissection under magnification and india ink and latex injection studies. The anterior interosseous artery divides into a muscular branch and a dorsal branch 1 cm to 3.5 cm from the proximal margin of the pronator quadratus muscle, and on its deep surface. Injection studies showed a rich periosteal plexus contributed by the anterior interosseous artery. Retrograde injection through the dorsal branch also showed good perfusion of the distal radius that was confirmed microscopically on bone sections. A muscle-bone graft from the anteromedial cortex of distal radius with an intact anterior interosseous artery has mobility of less than 2 cm. After ligating and dividing the anterior interosseous artery, blood supply to the distal radius bone flap relies on a retrograde flow and the bone flap could then be mobilized distally up to 4 to 6 cm.

Forearm↗
PubMed1990

Use of pronator quadratus bone flap in bony reconstruction around the wrist.

A bone graft can be raised from the distal end of the radius with intact blood supply derived from a vascular pedicle, i.e., the anterior interosseous artery proximally or the communicating branch from the dorsal carpal plexus distally. This graft has been used to produce proximal radiocarpal fusion, carpal bone replacement, and distal ulnar replacement. This viable graft with excellent blood supply gives very satisfactory clinical results.

Bone Transplantation↗
PubMed1990

An effective treatment of comminuted fractures of the distal radius.

One hundred cases of comminuted fracture of the distal radius were treated by a simple uniform method consisting of distraction by an external fixator for 3 weeks followed by functional bracing. During the application of the external fixator, autogenous cancellous bone chips were taken from the iliac crest and packed into the fracture site to realign the juxtaarticular fragments and to fill up the bone gap. Complications have been minimal. The results, after an average follow-up period of 20 months, taking into consideration subjective assessment of pain, objective measurement of wrist motion, and radiologic angles, have been excellent.

Adult↗
PubMed1990

Resurfacing difficult wounds: selective use of the posterior tibial flap.

The posterior tibial flap is a type C fasciocutaneous flap from the medial calf with the posterior tibial vascular bundle as its pedicle. Most of the skin perforators, 1 to 3 in number, can be found in the middle third of the leg, with an average diameter of 0.8 mm and an average length of 22 mm. The posterior tibial artery ranges between 1.5 and 2.0 mm in diameter, although it is absent in 8 percent of limbs. Since the saphenous nerve is taken with the flap, this is an innervated flap. The flap can be transferred as a free flap or a pedicled flap. The reversed-flow pedicled flap has an average pedicle length of 8 cm. The posterior tibial flap is a reliable, large, thin, innervated flap and can be raised with the patient supine. Case reports are presented of six patients who received a free flap transfer and of one patient who received a reversed-flow pedicled flap. There were two cases of heel ulcerations, two crushed hands, one chronic ulceration and osteomyelitis of the tibia, one burn contracture of the neck, and one salvage flap for diabetic gangrene of the hand.

Adult↗
PubMed1989

Experimental study on the behavior of a transplanted vascular pedicle.

The transparent chamber technique of the hamster cheek pouch was utilized to observe the behavior of a transplanted vascular pedicle within a relatively adverse environment. Observations included direct visualization with intravital microscopy, histology, scanning electron microscopy, and alkaline phosphatase staining for vascular endothelium. The results supported the phenomenon of vascular sprouting from the transplanted vascular pedicle.

Animals↗
PubMed1989

Combined intramedullary Kirschner wire and intra-osseous wire loop for fixation of finger fractures.

An intramedullary Kirschner wire was combined with an intra-osseous wire loop for fixing finger fractures. The mechanical stability of this technique to resist a bending moment in the sagittal plane was compared with four other conventional methods: single loop, loop and an oblique Kirschner wire, crossed Kirschner wires and dorsal plating. It was found that when the applied force was small, the technique was much more stable than the crossed Kirschner wires and was similar to the others. The ability to withstand mechanical failure was much better than most of the methods except the dorsal plate. This technique is recommended for replantations, transverse fractures and short oblique fractures with little comminution.

Animals↗
PubMed1989

Salvage of the ring avulsed finger in heavy manual workers.

Complete ring avulsion amputation (class III) injuries are difficult management problems, especially when they occur in heavy manual workers. By excising the bit of bone detached with the skin tube, opening up the skin tube into a flap and replanting it onto the proximal stump, two such cases were salvaged successfully, with early recovery of function. The fingers were shortened by 1.5 cm, had a normal nail, touch sensation and absence of cold intolerance and pain. Both of the patients returned to work in 4 months.

Adult↗
PubMed1988

Comparative study of artery cuff and fat wrap in microvascular anastomosis in the rat.

An artery cuff and a fat wrap placed around an anastomosis with only 4 stitches were compared to the conventional 8-10 stitches suturing technique in microvascular anastomosis: 120 vessels in 40 immature male S-D rats were used. Observations were made 1 hour, and 1, 2, 3 and 8 weeks after the repair. The newer techniques were performed faster, had shorter bleeding time and showed equivalent patency rates to the conventional technique. The artery cuff was slightly superior to the fat wrap, particularly in having fewer adhesions and a better histological picture. Clinical applications are discussed.

Adipose Tissue↗
PubMed1988

Primary malignant lymphoma of the deep tissues of the hand.

A 39-year-old tailor was seen initially with primary extranodal malignant lymphoma of the deep soft tissues of the right hand. The diagnosis was confirmed by immunocytochemical staining technique on the biopsy material. Review of the literature showed that this is a rare presentation. The prognosis is related to histologic grading. The patient received radiotherapy and the lesion responded rapidly. He was free of the disease 1 year later.

Adult↗
PubMed1988

Use of the medial plantar flap in soft tissue replacement around the heel region.

Large ulcers around the heel region are common but difficult problems because the usual methods of resurfacing are unsatisfactory. Twelve cases of such ulcers were covered with medial plantar vascular pedicled flaps and the results had been excellent. The operative procedures were simple and the quality of skin supplied was perfect. Different sizes of medial plantar flaps may be used, based on the available branches of the posterior tibial vessels.

Achilles Tendon↗