56
ity of the lumbar spine was evaluated based on the
angle between Ll and the line connecting the both
iliac crests on the A-P views and the angle between
Ll and L5 on the lateral views. The postoperative recovery of ADL was evaluated using Barthel Index serially.
Results: There was 6.3 degrees of scoliosis on
averagebeforesurgery. Althoughitwasimproved
to 2.6 degrees immediately after sinrgery, it was returned to 6.3 degrees at follow-up. As for the profile deformity, preoperative kyphosis of 23 degrees was improved to 12.2 degrees immediately after surgery. It was 17.9 degrees at follow-up. Dislocation-fracture cases showed more correction loss and deformity than those of burst-fracturecases. In all the cases we confirmed good mobility of the lumbar spines in both A-P and lateral views.
The cases of two-rod plate for burst fractures showed more prompt recovery of ADL than those of
incomplete lesion treated by Luque instrumentation,
Those of dislocation fractures treated by two-rod
plate surgery showed almost the same recovery curve as those of complete lesion treated by Luque instrumentation. In our series, the conservatively
treated groups showed the slowest recovery of the Barthel Index irrespective of incomplete or com-plete lesions.
Conclusions: The short-term results was
satis-factory in patients who underwent anterior two-rod
plate surgery for thoracolumbar spinal injuries. Incomplete thoracolumbar spinal injury was good
indication for this procedure.
EXPERIENCE 0F TISSUE EXPANDER
Y. IWAHIRA' and Y. MARUYAMA
Department of Plastic and Reconstructive Surgery,
Toho University Hospital, TOKYO
For the reconstructive surgeon, it is diflicult to
cover the wide defect with similar tissue in one
stage, because of limitation of the donor.
Soft tissue, skin, mucosa, and muscles
progres-sively expand over an underlying hematoma, a
slowlygrowingtumororpregnancy. Theprincipal
of tissue expander method is creating and develop-ing the donor tissue based on this natural phenome-non, using it, and still leaving the donor site preser-ved. It is achieved through the use of a silasticimplant capable of accumulating saline by forceful
injection through the valve system of the reservoir
dome. Internal pressure from within the expander
exerts its force on the flap, which gradually expands, providing additional tissue for
reconstruc-tlon. .
Since Radovan reported this method in 1976, the technique and clinical applications have come of
age in America. We were given some comments
from Radovan and have used for many cases.
These included burn scar, hemangioma, giant navus,soft tissue defect after trauma, alopecia, chest wall
defect after mastectomy et al. in all body. As a result, they were reconstructed with contiguous
tissue of similar texture, color, thickness and
sensa-tion. And now, we recognize it is a beneficial and
important method in reconstructing wide tissue
defect.
We present its advantages, clinical applications, operative technique, histological finding, and com-plication.
EXPERIENCES IN YAG LASER THERAPY OF
HEMANGIOMA
Y. IWAHIRA' and Y. MARUYAMA
Department of Plastic and Reconstructive Surgery, Toho University Hospital, Tokyo
Hemangiomas are common congenital vascular
lesions appearing mainly on the face, representing adisfigurement affecting many thousands of individ-uals. Multiple therapeutic modalities, including iaser therapies, Argon, C02, Ruby, Diode lasers et al., have been utilized with success. There are
many kinds of laser, each with its own
characteris-tics. We have used for treatment such different
lasers for different lesions and types. This report will present the experience in YAG laser therapy of
hemangioma out of all.
MMB Model Nd-YAG laser with a O . 6mm silastic treatment portal and O.1 to 3.9-sec pulse duration was used, set at 10 to 25J, 78 vascular lesions
(hemangioma)weretreated.
Theseincludeheman-gioma simplex, strawberry mark, cavernous type, teleangiectasia and others. We tried to achievedre-enithelization within 10 to 14 days. As a result,
YAG laser used revealed the most effective, least damaging one for each case. Some authors report-ed that YAG laser therapy is less effective and worthwhile than Argon and other procedures
