中国修复重建外科杂志最新文献

{"title":"[Application of musculoskeletal ultrasound combined with Wide-Awake technique in extensor indicis proprius tendon transfer for repairing extensor pollicis longus tendon rupture].","authors":"Xi Yang, Hua Fan, Xixiong Su, Xiang Fang, Yongqing Xu, Xiaoqing He","doi":"10.7507/1002-1892.202506034","DOIUrl":"10.7507/1002-1892.202506034","url":null,"abstract":"<p><strong>Objective: </strong>To explore effectiveness of musculoskeletal ultrasound combined with Wide-Awake technique in extensor indicis proprius tendon (EIP) transfer for repairing extensor pollicis longus tendon (EPL) rupture.</p><p><strong>Methods: </strong>A clinical data of 20 patients with EPL spontaneous rupture, who were admitted between January 2019 and June 2024 and met the selective criteria, was retrospectively analyzed. During EIP transfer surgery, the musculoskeletal ultrasound-guided incision marking combined with Wide-Awake technique was used in combination group (<i>n</i>=10) and the tourniquet-assisted surgery under brachial plexus block anesthesia in the control group. There was no significant difference in the baseline data between groups (<i>P</i>>0.05), including gender, age, affected side, cause and location of tendon rupture, and time from injury to hospitalization. The accuracy of preoperative musculoskeletal ultrasound in predicting the actual tendon rupture site was evaluated in the combination group. The operation time, intraoperative blood loss, visual analogue scale (VAS) scores during operation and at 6 hours after operation, total incision length, and postoperative complications were recorded. Surgical outcomes were assessed at 12 months after operation using the specific EIP-EPL evaluation method (SEEM), which included measurements of thumb elevation loss, thumb flexion loss, index finger dorsiflexion loss, and total score.</p><p><strong>Results: </strong>In the combination group, the incision position marked by preoperative musculoskeletal ultrasound positioning was consistent with the actual tendon rupture position. Compared with the control group, the operation time and total incision length in the combination group were significantly shorter and the VAS score at 6 hours after operation was significantly higher (<i>P</i><0.05). There was no significant difference in intraoperative blood loss or intraoperative VAS score between groups (<i>P</i>>0.05). All incisions in both groups healed by first intention. Two patients in the control group developed swelling and blisters in the tourniquet area, which subsided spontaneously without special treatment. All patients were followed up 12-14 months, with an average of 12.5 months. The thumb dorsiflexion function of all patients recovered to varying degrees. At last follow-up, the thumb elevation loss in combination group was significantly lower than that in control group, and the total score was significantly higher (<i>P</i><0.05); there was no significant difference in thumb flexion loss or index finger dorsiflexion loss between groups (<i>P</i>>0.05).</p><p><strong>Conclusion: </strong>Musculoskeletal ultrasound can accurately locate the site of tendon rupture, assist the Wide-Awake technique in implementing precise anesthesia, and adjust tendon tension while reducing tissue trauma, with satisfactory effectiveness.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 9","pages":"1149-1154"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effectiveness of innervated medial plantar flap for reconstruction of soft tissue defects following foot tumor resection].","authors":"Wenchao Zhang, Luqi Guo, Yan Hao, Liangya Wang, Chao Zhang, Yun Wang, Jiuzuo Huang, Ang Zeng, Xiao Long","doi":"10.7507/1002-1892.202506087","DOIUrl":"10.7507/1002-1892.202506087","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of the innervated medial plantar flap for reconstructing soft tissue defects, particularly in the weight-bearing zone, after resection of foot tumors.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 12 patients with malignant skin and soft tissue tumors of the foot treated between October 2023 and December 2024. The cohort included 8 males and 4 females, aged 42-67 years (mean, 57.5 years). Tumor types comprised malignant melanoma (5 cases), squamous cell carcinoma (4 cases), arsenical keratosis (2 cases), and tumor-induced osteomalacia (1 case). Soft tissue defects located in the heel weight-bearing region in 10 cases and non-weight-bearing ankle region in 2 cases, with defect sizes ranging from 4.0 cm×3.0 cm to 6.0 cm×4.0 cm. Preoperative photon-counting CT angiography (PC-CTA) was performed to assess the medial plantar artery and its perforators. All patients underwent radical tumor resection with confirmed negative margins. The resulting defects were reconstructed using a innervated medial plantar flap incorporating sensory branches of the medial plantar nerve. The flap donor site was covered with a split-thickness skin graft harvested from the ipsilateral inguinal region.</p><p><strong>Results: </strong>The operation was successfully completed in all 12 patients. All flaps survived completely without vascular compromise, partial necrosis, or total loss. Incisions healed primarily without dehiscence or infection. Minor skin graft necrosis occurred at the donor site in 3 patients, which healed within 2-3 weeks with routine dressing changes. No donor site complication (e.g., tendon or nerve injury) occurred. Patients were followed up 2-16 months (mean, 10.3 months). At last follow-up, there was no tumor recurrence. Flaps exhibited good color and texture match with surrounding tissue, restored sensation, and all feet achieved normal weight-bearing activity.</p><p><strong>Conclusion: </strong>The innervated medial plantar flap, precisely designed based on PC-CTA localization, provides reliable blood supply and effective sensory restoration. It is an ideal method for reconstructing soft tissue defects after foot tumor resection, especially in the heel weight-bearing region.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 9","pages":"1086-1090"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Early internal fixation combined with free anterolateral thigh perforator flap transplantation to treat open ankle fracture-dislocation].","authors":"Xingfeng Hu, Xiang Wang, Liang Ji, Wei Liang, Qixin Luo, Yang Peng, Qingsong Li","doi":"10.7507/1002-1892.202505079","DOIUrl":"10.7507/1002-1892.202505079","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of early internal fixation combined with free anterolateral thigh perforator flap (ALTPF) transplantation in the treatment of open ankle fracture-dislocation.</p><p><strong>Methods: </strong>A retrospective analysis was performed on the clinical data of 13 patients with open ankle fracture-dislocation who were admitted and met the inclusion criteria between January 2021 and May 2024. Among them, there were 9 males and 4 females, with the ages ranging from 23 to 61 years (mean, 45.3 years). Fracture types included 5 cases of simple medial or lateral malleolar fracture-dislocation, 7 cases of bimalleolar (medial and lateral) fracture-dislocation, and 1 case of trimalleolar fracture-dislocation. Additionally, 3 cases were complicated with bone defects (1 medial malleolus defect and 2 lateral malleolus defects). All injuries were classified as type ⅢB according to the Gustilo-Anderson classification for open fractures. The size of wound defects ranged from 7 cm×5 cm to 18 cm×12 cm. The time from injury to surgery was 2-20 hours (mean, 4 hours). All patients underwent emergency thorough debridement upon admission. The fracture-dislocation was temporarily stabilized with an external fixator, and the wound was covered with antibiotic-impregnated bone cement sheets or vacuum sealing drainage. Definitive internal fixation of the fracture and free ALTPF transplantation were performed 5-7 days after the initial emergency procedure. Postoperatively, wound healing, flap survival, and fracture union were monitored. At last follow-up, clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score.</p><p><strong>Results: </strong>All 13 patients were followed up 6-24 months (mean, 8.2 months). All flaps survived completely, and all fractures achieved union, with an union time of 3-11 months (mean, 5.5 months). One patient developed a superficial infection at the wound margin, which healed after regular dressing changes and drainage. No internal fixation-related complication (e.g., deep infection, implant loosening, or secondary ankle instability) were observed. At last follow-up, the total AOFAS ankle-hindfoot score was 78.6±13.5, with 3 excellent, 7 good, 2 fair, and 1 poor cases, yielding an excellent and good rate of 76.9%.</p><p><strong>Conclusion: </strong>Early internal fixation combined with ALTPF transplantation for open ankle fracture-dislocation can shorten the treatment course and maximize the recovery of ankle joint function.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 9","pages":"1175-1179"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application and innovation of functional perforator flaps in reconstruction of tissue defects].","authors":"Xin Wang, Jiadong Pan","doi":"10.7507/1002-1892.202508001","DOIUrl":"10.7507/1002-1892.202508001","url":null,"abstract":"<p><strong>Objective: </strong>To review the nomenclature, functional unit construction, technical essentials, and prevention and treatment of complications of functional perforator flaps, so as to provide references for the structural and functional reconstruction of composite tissue defects.</p><p><strong>Methods: </strong>By retrieving and analyzing domestic and foreign literature on anatomical research, technical innovation and clinical application of functional design and application of perforator flaps, combined with the clinical practice of our team, the methods for harvesting and integrating functional units of perforator flaps were summarized.</p><p><strong>Results: </strong>Functional perforator flap refers to a perforator flap that, on the basis of perforator blood supply, carries one or more tissue functional units (such as muscles, nerves, lymphatic vessels, lymph nodes, bones, mucous membranes, joints or articular cartilages, <i>etc</i>.) with sufficient blood supply located in the supra-fascia and/or sub-fascia, and is used to reconstruct one or more functions of the recipient site. The design and transfer of functional perforator flaps should not only meet the needs of precise coverage of the wound, but also reconstruct the functions of the recipient site such as muscle contraction, flap sensation, lymphatic drainage, blood flow bridging, bone growth, glandular secretion or joint movement, while avoiding iatrogenic dysfunction in the donor site.</p><p><strong>Conclusion: </strong>Functional perforator flaps have broken through the limitation of \"wound coverage\" and realize the integrated reconstruction of \"structure-function-aesthetics\".</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 9","pages":"1071-1075"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Establishment of a canine model of vascularized allogeneic spinal cord transplantation and preliminary study on spinal cord continuity reconstruction].","authors":"Jiayang Chen, Rongyu Lan, Weihua Zhang, Jie Qin, Weijun Hu, Jiaxing Wang, Xiaoping Ren","doi":"10.7507/1002-1892.202505014","DOIUrl":"10.7507/1002-1892.202505014","url":null,"abstract":"<p><strong>Objective: </strong>To explore the construction of a canine model of vascularized allogeneic spinal cord transplantation (vASCT) and preliminarily evaluate its therapeutic efficacy for spinal cord injury (SCI).</p><p><strong>Methods: </strong>Sixteen female Beagle dogs aged 8-12 months were randomly selected, with 8 dogs serving as donors for the harvesting of spinal cord tissue with a vascular pedicle [dorsal intercostal artery (DIA) at the T₁₀ level and accompanying vein]. The remaining 8 dogs underwent a 1.5-cm-length spinal cord defect at the T₁₀ level, followed by transplantation of the donor spinal cord tissue for repair. Polyethylene glycol (PEG) was applied to both ends to spinal cord graft; then, using a random number table method, the dogs were divided into an experimental group (<i>n</i>=4) and a control group (<i>n</i>=4). The experimental group received immunosuppressive intervention with oral tacrolimus [0.1 mg/(kg∙d)] postoperatively, while the control group received no treatment. The operation time and ischemia-reperfusion time of two groups were recorded. The recovery of hind limb function was estimated by Olby score within 2 months after operation; the motor evoked potentials (MEP) was measured through neuroelectrophysiological examination, and the spinal cord integrity was observed through MRI.</p><p><strong>Results: </strong>There was no significant difference in the operation time and ischemia-reperfusion time between the two groups (<i>P</i>>0.05). All dogs survived until the completion of the experiment. Within 2 months after operation, all dogs in the control group failed to regain the movement function of hind limbs, and Olby scores were all 0. In the experimental group, the movement and weight-bearing, as well as walking abilities of the hind limbs gradually recovered, and the Olby scores also showed a gradually increasing trend. There was a significant difference between the two groups from 3 to 8 weeks after operation (<i>P</i><0.05). Neuroelectrophysiological examination indicated that the electrical signals of the experimental group passed through the transplanted area, and the latency was shortened compared to that at 1 month after operation (<i>P</i><0.05), showing continuous improvement, but the amplitude did not show significant improvement (<i>P</i>>0.05). The control group was unable to detect any MEP changes after operation. MRI examination showed that the transplanted spinal cord in the experimental group survived and had good continuity with normal spinal cord tissue, while no relevant change was observed in the control group.</p><p><strong>Conclusion: </strong>The vASCT model of dogs was successfully constructed. This surgical procedure can restore the continuity of the spinal cord. The combination of tacrolimus anti-immunity is a key factor for the success of transplantation.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 9","pages":"1196-1202"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Short-term effectiveness of edge-to-edge #-shaped suture for complete radial tear of lateral meniscus body].","authors":"Hehe Zhong, Jing Chen, Pengpeng Sun, Dongfeng Cai, Lidan Yang, Huazhang Xiong, Shuhong Wu","doi":"10.7507/1002-1892.202504026","DOIUrl":"10.7507/1002-1892.202504026","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the surgical method and short-term effectiveness of arthroscopy edge-to-edge #-shaped suture in the treatment of the complete radial tear of the lateral meniscus body.</p><p><strong>Methods: </strong>The clinical data of 13 patients with complete radial tear of lateral meniscus body between May 2020 and August 2023 were retrospectively analyzed. There were 10 males and 3 females, aged 15-38 years (mean, 24.2 years). There were 11 cases of acute injury and 2 cases of chronic injury, with time from injury to admission ranging from 2 days to 5 months. All patients had tenderness in the lateral joint space, and 2 patients with chronic injury had positive McMurray's sign. All patients were treated with arthroscopic edge-to-edge #-shaped suture technique. The knee joint activity and tenderness in the lateral joint space were detected, and the healing of the incision and the occurrence of complications were observed. X-ray films and MRI of the knee joint were performed to evaluate joint degeneration and meniscus healing. Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Tegner score, and visual analogue scale (VAS) score were used to evaluate the functional recovery before and after operation.</p><p><strong>Results: </strong>The operation time ranged from 46 to 100 minutes (mean, 80.08 minutes). All the incisions healed by first intention, and no complication such as intraoperative vascular and nerve injury or postoperative infection occurred. All 13 patients were followed up 20-59 months (mean, 29.3 months). All patients had no limitation of knee extension and flexion. One patient with chronic injury continued to have tenderness in the lateral space of the knee joint, while the remaining patients had no tenderness, swelling, and locking in the lateral space. Immediate postoperative MRI of knee joint showed continuous recovery of the lateral meniscus. At last follow-up, no degenerative changes were observed in X-ray films of knee joint. Except for 1 patient with chronic injury, the MRI of the other patients showed the healing performance after lateral meniscus suture. Lysholm score, IKDC subjective score, Tegner score, and VAS score all significantly improved when compared with those before operation (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>The edge-to-edge #-shaped suture technique can effectively repair the complete radial tear of the lateral meniscus body, and the short-term effectiveness is satisfactory.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 9","pages":"1165-1169"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Single-stage treatment of upper limb lymphedema following breast cancer surgery using superficial circumflex iliac artery perforator-based vascularized lymph node transfer combined with lymphaticovenular anastomosis and liposuction].","authors":"Zongcan Chen, Junzhe Chen, Yuanyuan Wang, Lingli Jiang, Xiangkui Wu, Hai Li, Shune Xiao, Chengliang Deng","doi":"10.7507/1002-1892.202506113","DOIUrl":"10.7507/1002-1892.202506113","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare the effectiveness of single-stage vascularized lymph node transfer (VLNT) combined with lymphaticovenular anastomosis (LVA) and liposuction (LS) (3L) versus LVA combined with LS (2L) for the treatment of moderate-to-late stage upper limb lymphedema following breast cancer surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on the clinical data of 16 patients with moderate-to-late stage upper limb lymphedema after breast cancer surgery, treated between June 2022 and June 2024, who met the selection criteria. Patients were divided into 3L group (&lt;i&gt;n&lt;/i&gt;=7) and 2L group (&lt;i&gt;n&lt;/i&gt;=9) based on the surgical approach. There was no significant difference (&lt;i&gt;P&lt;/i&gt;&gt;0.05) in baseline data between the groups, including age, body mass index, duration of edema, volume of liposuction, International Society of Lymphology (ISL) stage, preoperative affected limb volume, preoperative circumferences of the affected limb at 12 levels (from 4 cm distal to the wrist to 42 cm proximal to the wrist), preoperative Lymphoedema Quality of Life (LYMQoL) score, and frequency of cellulitis episodes. The 2L group underwent LS on the upper arm and proximal forearm and LVA on the middle and distal forearm. The 3L group received additional VLNT in the axilla, with the groin serving as the donor site. Outcomes were assessed included the change in affected limb volume at 12 months postoperatively, and comparisons of limb circumferences, LYMQoL score, and frequency of cellulitis episodes between preoperative and 12-month postoperative. Ultrasound evaluation was performed at 12 months in the 3L group to assess lymph node viability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Both groups were followed up 12-20 months, with an average of 15.13 months. There was no significant difference in the follow-up time between the groups (&lt;i&gt;t&lt;/i&gt;=-1.115, &lt;i&gt;P&lt;/i&gt;=0.284). All surgical incisions healed by first intention. No adverse events, such as flap infection or necrosis, occurred in the 3L group. At 12 months after operation, ultrasound confirmed good viability of the transferred lymph nodes in the 3L group. Palpation revealed significant improvement in skin fibrosis and improved skin softness in both groups. Affected limb volume significantly decreased in both groups postoperatively (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The reduction in limb volume significantly greater in the 3L group compared to the 2L group (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Circumferences at all 12 measured levels significantly decreased in both groups compared to preoperative values (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The reduction in circumference at all 12 levels was better in the 3L group than in the 2L group, with significant differences observed at 7 levels (8, 12, 16, 30, 34, 38, and 42 cm) proximal to the wrist (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Both groups showed significant improvement in the frequency of cellulitis episodes and LYMQoL scores postoperatively (&lt;i&gt;P&lt;/i&gt;&lt;0.05). While the improvement in LYMQoL scores at 12 months d","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 9","pages":"1114-1121"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Antegrade elastic intramedullary nailing fixation via a novel approach through proximal radius for distal radius metaphyseal-diaphyseal junction fractures in children].","authors":"Bin Jin, Xinglei Shi, Hailong Ma, Junchen Zhu","doi":"10.7507/1002-1892.202506027","DOIUrl":"10.7507/1002-1892.202506027","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the surgical technique and preliminary effectiveness of closed reduction and internal fixation (CRIF) using antegrade elastic intramedullary nailing (ESIN) via a novel approach through the proximal radius for treating distal radius metaphyseal-diaphyseal junction (DRMDJ) fractures in children.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 34 children with DRMDJ fractures who met the selection criteria and were treated between January 2020 and June 2023. There were 21 boys and 13 girls, aged 6-14 years (mean, 8.2 years). Injury causes included falls in 11 cases and sports-related trauma in 23 cases. Twenty-six cases were associated with ipsilateral distal ulnar fractures. All patients had failed initial closed reduction in the outpatient clinic. The time from injury to operation ranged from 1 to 15 days (mean, 4 days). All patients underwent CRIF using antegrade ESIN inserted via a novel approach at the proximal one-third of the radius. The operation time, intraoperative fluoroscopy frequency, fracture healing time, and complications were recorded. Fracture reduction was assessed immediately after operation on anteroposterior and lateral X-ray films for residual translation and angulation. Wrist function was evaluated using the modified Mayo wrist score.</p><p><strong>Results: </strong>Surgery was successfully completed in all 34 children. CRIF with ESIN failed in 2 cases with associated ipsilateral distal ulnar fractures, requiring conversion to open reduction of the ulna. Operation time ranged from 15 to 56 minutes (mean, 21 minutes). Intraoperative fluoroscopy frequency ranged from 5 to 21 times (mean, 7 times). Immediate postoperative X-ray films showed residual translation of 0-15% on anteroposterior view and 0-10% on lateral view, and residual angulation of 0°-5° on both anteroposterior and lateral views. All children were followed up 6-18 months (mean, 12 months). There was no complication such as neurovascular injury, incision infection, or limitation of forearm rotation. Follow-up X-ray films showed no fracture displacement, implant loosening, delayed union, or nonunion. Fracture healing time ranged from 4 to 8 weeks (mean, 6 weeks). Implants were removed at 4-6 months postoperatively (mean, 5 months). At last follow-up, all fractures had achieved anatomic or near-anatomic healing. The modified Mayo wrist score ranged from 80 to 100 (mean, 94), with 27 excellent and 7 good results, yielding an excellent and good rate of 100%.</p><p><strong>Conclusion: </strong>CRIF using antegrade ESIN via a novel approach through proximal radius is a safe and effective treatment for pediatric DRMDJ fractures, associated with few postoperative complications and excellent restoration of wrist function.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 9","pages":"1155-1159"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnostic value of ^99mTc-MDP three-phase bone scintigraphy combined with C-reaction protein for periprosthetic joint infection].","authors":"Guojie Liu, Xiaolan Song, Pei Zhai, Shipeng Song, Weidong Bao, Yawei Duan, Wei Zhang, Yafeng Liu, Yongqiang Sun, Shuailei Li","doi":"10.7507/1002-1892.202505091","DOIUrl":"10.7507/1002-1892.202505091","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the diagnostic efficacy of ^99mTc-MDP three-phase bone scintigraphy (TPBS) combined with C-reactive protein (CRP) for periprosthetic joint infection (PJI).</p><p><strong>Methods: </strong>The clinical data of 198 patients who underwent revision surgery of artificial joint between January 2017 and January 2024 and received TPBS examination before surgery were retrospectively analyzed. There were 77 males and 121 females with an average age of 63.74 years ranging from 24 to 92 years. There were 90 cases of hip arthroplasty and 108 cases of knee arthroplasty. PJI was diagnosed according to the 2013 American Musculoskeletal Infection Society (MSIS) standard diagnostic criteria. The sensitivity, specificity, accuracy, negative predictive value (NPV), and positive predict value (PPV) were calculated. The receiver operating characteristic (ROC) curve was used to compare the diagnostic performance of the three methods, and the area under curve (AUC) was used to evaluate the diagnostic performance.</p><p><strong>Results: </strong>According to the 2013 MSIS criteria, 116 cases were diagnosed as PJI, and the remaining 82 cases were aseptic loosening. The cases of PJI diagnosed by TPBS, CRP, and TPBS-CRP were 125, 109, and 137 respectively, and the cases of aseptic loosening were 73, 89, and 61 respectively. The sensitivity, accuracy, NPV, and PPV of TPBS-CRP combination in the diagnosis of PJI were higher than those of TPBS and CRP, but the specificity was lower than that of TPBS and CRP. ROC curve analysis further showed that the AUC value of TPBS-CRP combination was better than that of TPBS and CRP. The severity of bone defect and the duration of symptoms in patients with false positive TPBS diagnosis were worse than those in patients with true negative TPBS diagnosis (<i>P</i><0.05), but there was no significant difference in the survival time of prosthesis between the two groups (<i>P</i>>0.05). Among the patients diagnosed with PJI by TPBS, CRP, and TPBS-CRP, 49, 35, and 54 patients had received antibiotic treatment 2 weeks before diagnosis, respectively. There was no significant difference in the diagnostic accuracy of TPBS and TPBS-CRP before diagnosis between patients treated with and without antibiotics and those not treated (<i>P</i>>0.05). The diagnostic accuracy of antibiotic therapy before CRP diagnosis was significantly lower than that of untreated patients (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>TPBS and CRP have limited specificity in differentiating PJI from aseptic loosening. The TPBS-CRP combination diagnostic method can synergize the local bone metabolic characteristics and systemic inflammatory response to achieve higher diagnostic accuracy, but caution should be exercised in patients with severe bone defects and longer symptom duration.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 9","pages":"1180-1186"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Functional chimeric perforator flap of medial femoral condyle for osteochondral and soft tissue reconstruction in hand and foot joints].","authors":"Mingwu Zhou, Yanfeng Li, Yang Gao, Kai Zhang, Zhiwei Zhao, Kuo Wei, Jia Chen","doi":"10.7507/1002-1892.202506115","DOIUrl":"10.7507/1002-1892.202506115","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the effectiveness of free medial femoral condyle (MFC) functional chimeric perforator flap (FCPF) transplantation in reconstructing joint function by repairing concomitant osteochondral defects and soft tissue defect in hand and foot joints.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was performed on 6 patients (5 males, 1 female; mean age of 33.4 years, range 21-56 years) with traumatic osteochondral joint defects and associated tendon, nerve, and soft tissue defects treated between January 2019 and November 2024. Defect locations included metacarpal heads (&lt;i&gt;n&lt;/i&gt;=2), metacarpophalangeal joint (&lt;i&gt;n&lt;/i&gt;=1), first metatarsal head (&lt;i&gt;n&lt;/i&gt;=1), base of first proximal phalanx (&lt;i&gt;n&lt;/i&gt;=1), and talar head (&lt;i&gt;n&lt;/i&gt;=1), with soft tissue defects in all cases. Osteochondral defect sizes ranged from 1.5 cm×1.2 cm×0.7 cm to 4.0 cm×0.6 cm×0.6 cm, and skin defects ranged from 4 cm×3 cm to 13 cm×4 cm. The stage Ⅰ treatment included debridement, antibiotic-loaded bone cement filling of bone-cartilage defects, fracture internal fixation, and coverage with vacuum sealing drainage. Stage Ⅱ involved harvesting a free MFC- FCPF included an osteochondral flap (range of 1.5 cm×1.2 cm×0.7 cm to 4.0 cm×0.6 cm×0.6 cm), gracilis and/or semitendinosus tendon grafts (length of 4-13 cm), saphenous nerve graft (length of 3.5-4.0 cm), and a perforator skin flap (range of 6 cm×4 cm to 14 cm×6 cm), each with independent vascular supply. The flap was transplanted to reconstruct joint function. Donor sites were closed primarily or with skin grafting. Flap survival was monitored postoperatively. Radiographic assessment was used to evaluate bone/joint healing. At last follow-up, the joint function recovery was assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All 6 MFC-FCPF survived completely, with primary healing of wounds and donor sites. All patients were followed up 6-44 months (mean, 23.5 months). The flaps at metacarpophalangeal joint in 1 case and at ankle joint in 1 case were treated with degreasing repair because of their bulky appearance, while the other flaps had good appearance and texture. At 3 months after operation, the visual analogue scale (VAS) score for pain during joint movement of recipient site was 0-2, with an average of 0.7; at last follow-up, the VAS score of the donor site was 0-1, with an average of 0.3. According to the Paley fracture healing scoring system, the osteochondral healing of all the 6 patients was excellent. The range of motion of the metacarpophalangeal joint in 3 cases was 75%, 90%, and 100% of contralateral side respectively, the range of motion of the metatarsophalangeal joint in 2 cases was 65% and 95% of contralateral side respectively, and the range of motion of the ankle joint in 1 case was 90% of contralateral side. The hand function was evaluated as excellent in 2 cases and good in 1 case according to the upper limb function evaluation standard of the Chinese Medical Association ","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 9","pages":"1106-1113"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}