• Title/Summary/Keyword: Peroneal nerve

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A Case Report of Foot Drop in Soyangin Improved with Sukjiwhanggosam-tang (숙지황고삼탕(熟地黃苦蔘湯)으로 호전된 소양인(少陽人) 족하수(足下華) 치험 1례)

  • Han, Da-Nim;Lee, Pil-Jae;Kim, Seong-Ki;Lim, Eun-Chul;Jung, Ji-Eun
    • Journal of Sasang Constitutional Medicine
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    • v.21 no.1
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    • pp.270-277
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    • 2009
  • 1. Objectives The purpose of this case study is to report the effects of Sukjiwhanggosam-tang which is based on the Sasang Constitutional Medicine for the Foot drop caused by peroneal nerve palsy. 2. Methods This patient was treated by Sukjiwhanggosam-tang according to the result of Sasang Constitutional diagnosis. We used Visual analogue scale(VAS), Range of motion(ROM) and Manual Muscle Testing(MMT) to evaluate the improvement of the Foot drop. 3. Results After 20 days treatment, the VAS of Rt. leg & foot hypoesthesia decreased from 10 to 2. The ROM of dorsiflexion of the ankle joint increased from $10^{\circ}$ to $30^{\circ}$ and the grade of MMT increased from 3 to 4. 4. Conclusions This case study shows an efficient result of using Sukjiwhanggosam-tang in the treatment of the Foot drop caused by peroneal nerve palsy.

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A STUDY OF THE EFFECT OF CULTURED BONE MARROW STROMAL CELLS ON PERIPHERAL NERVE REGENERATION (체외 배양한 골수줄기세포를 이용한 말초신경재생에 관한 연구)

  • Choi, Byung-Ho;Zhu, Shi-Jiang;Jung, Jae-Hyung;Huh, Jin-Young;Lee, Seoung-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.6
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    • pp.492-495
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    • 2005
  • The role of cultured bone marrow stromal cells (BMSCs) in peripheral nerve regeneration was examined using an established rabbit peroneal nerve regeneration model. A 15-mm peroneal nerve defect was bridged with a vein filled with BMSCs $(1{\times}10^6)$, which had been embedded in collagen gel. On the contralateral side, the defect was bridged with a vein filled with collagen gel alone. When the regenerated tissue was examined 4, 8 and 12 weeks after grafting, the number and diameter of the myelinated fibers in the side with the BMSCs were significantly higher than in the control side without the BMSCs. This demonstrates the potential of using cultured BMSCs in peripheral nerve regeneration.

Survival of Neuro-Venous Flap without Perforator due to Accidental Division of Perforator (돌발적 손상에 의해 천공지가 없는 신경-정맥피판의 생존)

  • Byeon, Je Yeon;Choi, Hwan Jun
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.290-295
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    • 2018
  • Author planed peroneal artery perforator flap for ankle reconstruction and experienced successful result using sural neuro-lesser saphenous venous flap due to an unexpected event. A male Asian patient, 24 years old, had a history of recurrent operation wound disruption in the ankle region. Under general anesthesia, peroneal perforator and saphenous vein, as well as the sural nerve branches, were identified and preserved. In the process of flap rotation, an accidental division of peroneal artery perforator has occurred. Despite the division of the perforator, circulation was normal. The patient experienced no complication after the surgery. Some study reported that accompanying arteries and the vascular plexus around the sural nerve communicate. In conclusion, sufficient blood supply was possible only with the accompanying artery of the sural nerve without peroneal perforator. So, it is essential to always preserve not only perforator but also neurovascular bundles at any circumstances and any location.

Sacral Nerve Stimulation Through the Sacral Hiatus

  • Park, Chan-Hong;Kim, Bong-Il
    • The Korean Journal of Pain
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    • v.25 no.3
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    • pp.195-197
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    • 2012
  • Sacral nerve stimulation through the retrograde approach has been used for peroneal or irritable bowel syndrome through the retrograde approach. However, several reasons, lead could not be advanced down ward. In this case, anterograde sacral nerve stimulation through the sacral hiatus could be used. The aim of this report is to present of technique of sacral nerve root stimulation through the sacral hiatus approach.

Peroneal Perforator Flap (비골 동맥 천공지 피판)

  • Chung, Duke Whan;Hwang, Joon Sung
    • Archives of Reconstructive Microsurgery
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    • v.13 no.1
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    • pp.29-35
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    • 2004
  • Materials and Methods: Total number of peroneal perforator flap is 14 cases, which 10 cases were man, 4 cases were woman. The range of age was 12 years old minimally and until 63 years old. The trauma was most common etiology, which was like traffic accidents, 9 cases. We confirmed tibialis anterior artery patency by doppler flow meter, angiography as preoperative evaluation. Results: 1. The success rate was 91%, that in 14 cases, 13 cases were succeded. 2. To obtain successful result of peroneal flap, one must have the anatomic concept for vascular pattern, 8 cases were between peroneus muscle and soleus muscle branch type but, 3 cases were through soleus muscle branch type, so we treated these cases by using soleus muscle including peroneal perforating branch not to injury perforating artery directly. 3. The pedicle size was between minimally $2{\times}2.5cm$ and maximally $6.5{\times}8.5cm$ so we could treat large recipient site. 4. The pedicle length was between minimally 3.2 cm and maximally 11.5cm, average 7.5 cm. 5. The diameter of perforating artery was estimated by inspection, that was about 0.2-0.5 cm Conclusion: The peroneal perforating artery flap has merits that we can approach in avascular zone and has wide movable range from foot to distal femur and little donor site mobidity and can harvest osteocutaneous flap. The weak point was the irregular anatomy of nutrient artery and not to contain sensory nerve.

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A case of neonatal peroneal neuropathy with intrauterine onset (신생아 종아리신경병증 1례)

  • Lee, Sang-Soo;Sim, Ji-Yun;Kim, Mi-Jung
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.585-587
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    • 2007
  • Peroneal neuropathy presenting at birth is a rare disorder. Although neonatal mononeuropathies may be related to obstetrical complications, prenatal mechanisms should be also considered. We describe an infant who was born at term by cesarean section due to breech presentation with a unilateral footdrop. Lack of compound muscle action potential in the peroneal nerve and denervation potentials confined to the tibialis anterior and the extensor hallucis longus muscles in the electrophysiological studies on the fourth day of life strongly suggest an isolated peroneal neuropathy of intrauterine onset. Early and sequential electrodiagnostic studies will be important to provide better temporal and pathophysiologic definitions, the better timing of onset and prognosis for mononeuropathies presenting in newborn infants.

Transplantation of the Neurosensory Free Flaps to the Hand (수부에 시행한 신경감각 유리 조직 이식술)

  • Lee, Jun-Mo;Lee, Ju-Hong
    • Archives of Reconstructive Microsurgery
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    • v.9 no.2
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    • pp.120-126
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    • 2000
  • Microsurgical reconstruction of the hand demands recovery of the sensation of the reconstructed free flap as well as microsurgeon's intelligence, technique and experience. Even with adequate soft tissue coverage and skeletal mobility, an insensate hand is prone to further injury and is unlikely to be useful to the patients. Authors have performed 8 cases of neurosensory free flaps in the hand, 4 cases of wrap around, 3 dorsalis pedis and 1 lateral arm flap, from July 1992 through June 1999 and followed up average 4 years and 4 months. Wrap around flap was performed for reconstruction of 4 cases of thumb, repairing deep peroneal nerve and superficial radial nerve by epineurial neurorrhaphy, and followed up for average 3 years and 10 months and calculated 9mm in the static 2 point discrimination test. Dorsalis pedis flap were 3 cases for reconstruction of the ray amputation, extensor tendon exposure and wrist exposure. Deep peroneal nerve and branch of the ulnar nerve was repaired by epineurial neurorrhaphy calculating 6mm and superficial peroneal nerve and superficial radial nerve averaging 18mm in the static 2 point discrimination test for follow up average 2 years and 9 months. Lateral arm flap was 1 case for reconstruction of the ray amputation in the hand repairing posterior cutaneous nerve to the arm to the superficial radial nerve calculating 20mm for follow up 6 years and 8 months.

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Distally Based Sural Artery Adipofascial Flap based on a Single Sural Nerve Branch: Anatomy and Clinical Applications

  • Mok, Wan Loong James;Por, Yong Chen;Tan, Bien Keem
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.709-715
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    • 2014
  • Background The distally based sural artery flap is a reliable, local reconstructive option for small soft tissue defects of the distal third of the leg. The purpose of this study is to describe an adipofascial flap based on a single sural nerve branch without sacrificing the entire sural nerve, thereby preserving sensibility of the lateral foot. Methods The posterior aspect of the lower limb was dissected in 15 cadaveric limbs. Four patients with soft tissue defects over the tendo-achilles and ankle underwent reconstruction using the adipofascial flap, which incorporated the distal peroneal perforator, short saphenous vein, and a single branch of the sural nerve. Results From the anatomical study, the distal peroneal perforator was situated at an average of 6.2 cm (2.5-12 cm) from the distal tip of the lateral malleolus. The medial and lateral sural nerve branches ran subfascially and pierced the muscle fascia 16 cm (14-19 cm) proximal to the lateral malleolus to enter the subcutaneous plane. They merged 1-2 cm distal to the subcutaneous entry point to form the common sural nerve at a mean distance of 14.5 cm (11.5-18 cm) proximal to the lateral malleolus. This merging point determined the pivot point of the flap. In the clinical cases, all patients reported near complete recovery of sensation over the lateral foot six months after surgery. All donor sites healed well with a full range of motion over the foot and ankle. Conclusions The distally based sural artery adipofascial flap allowed for minimal sensory loss, a good range of motion, an aesthetically acceptable outcome and can be performed by a single surgeon in under 2 hours.

Change of gait pattern of a patient with cerebral stroke by peroneal nerve stimulation therapy (뇌졸중 환자의 비골신경 자극에 따른 보행 양상의 변화)

  • Choi, Sanho;Lee, Ilsuk;Hong, Haejin;Oh, Jaegun;Sung, Kang-keyng;Lee, Sangkwan
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.14 no.1
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    • pp.61-70
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    • 2013
  • ■ Objectives The goal of this pilot study is to observe the change of gait pattern in a patient after peroneal nerve electrical stimulation(PNST). ■ Methods We analyzed the gait pattern of stroke patient using treadmill gait analysis system before and after PNST for seven weeks. The PNST was carried out for 20minutes every day except Sunday. In addition, the measurement was carried out every Saturday. At the fifth week, the PNST was not carried out to confirm whether the effect of PNST was disappeared immediately when PNST was not applied. ■ Results After PNST, while heel contact time and heel max force increased and forefoot and midfoot max force decreased, the gait parameters such as cadence, velocity, swing phase, stance phase, total double support, step length, stride length, step time, stride time and forefoot contact time, were not changed. ■ Conclusion Gait of a patient with cerebral stroke was changed positively after PNST.

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Suggestion on Locating Method for ST36 Acupoint Based on Neuroanatomical Features (족삼리 취혈방식 제안: 신경해부학적 특성을 기반으로)

  • Heeyoung Moon;Da-Eun Yoon;Yeonhee Ryu;In-Seon Lee;Dody Chang;Poney Chiang;Younbyoung Chae
    • Korean Journal of Acupuncture
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    • v.40 no.3
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    • pp.128-133
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    • 2023
  • Objectives : There are many variations in the ST36 acupoint location. The purpose of this article is to suggest a method of locating the ST36 acupoint. Methods : Based on the available research and the neuroanatomical characteristics of the underlying acupoint, we summarized the proper procedure for finding the ST36 acupoint. Results : ST36 is 3 B-cun inferior to ST35 and is vertically situated on the line that connects ST35 and ST41. The ST36 acupoint corresponds to the deep peroneal nerve, which is situated in the tibialis anterior muscle's back. The neurovascular bundles that are located on the interosseous membrane between the interosseous crests of the tibia and fibula include the deep peroneal nerve, anterior tibial artery, and anterior tibial vein. According to both classical and modern literature, this acupoint can be found horizontally between the two muscles, tibialis anterior and extensor digitorum longus. Conclusions : Based on a review of the literature and neuroanatomical features, we suggest that ST36 can be positioned horizontally between tibialis anterior and extensor digitorum longus. Additional imaging studies and clinical proof are required to determine ST36 acupoint.