中华显微外科杂志最新文献

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Applied anatomied study in bilobed micro-flap of second dorsal metacarpal artery and dorsal digital artery 第二掌背动脉和指背动脉双叶微型皮瓣的应用解剖研究
中华显微外科杂志 Pub Date : 2019-12-25 DOI: 10.3760/CMA.J.ISSN.1001-2036.2019.06.011
Yu Chunbo, Liu Peng, Liang Yachuang, Zhao Qinghao, Ding Zi-hai, Z. Zhifeng
{"title":"Applied anatomied study in bilobed micro-flap of second dorsal metacarpal artery and dorsal digital artery","authors":"Yu Chunbo, Liu Peng, Liang Yachuang, Zhao Qinghao, Ding Zi-hai, Z. Zhifeng","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.06.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.06.011","url":null,"abstract":"Objective \u0000To observe the location and the distribution of distal 1/3 segment of the second dorsal metacarpal artery, the finger web artery and the dorsal digital artery, and to provide anatomical data for repairing the soft tissue defect on the hand with bilobed or multi-lobed micro-flap with second metacarpal dorsal artery-dorsal digital artery. \u0000 \u0000 \u0000Methods \u0000From June, 2018 to March, 2019, 34 fresh adult upper limb specimens were selected. The radial and ulnar arteries were perfused with red latex in 24 specimens. The radial and ulnar arteries were infused with cast materials to make cast specimens in 10 specimens. The location and distribution of the distal 1/3 segment of the second dorsal metacarpal artery, the finger web and the dorsal digital artery were observed. \u0000 \u0000 \u0000Results \u0000The distal 1/3 segment of second dorsal metacarpal artery extended (4±1) cutaneous branches, and continued to become the finger web artery at the plane of the articular surface. The length of the finger web artery was (2.5±0.6) cm, and there were 4 types anastomic methods of communication with arteries. The second dorsal metacarpal artery extended 2 finger dorsal artery to the proximal dorsal skin of the middle finger and index finger. The length of dorsal digital artery was 2.6±0.4 cm and the diameter was 0.2±0.1 mm. Four to 6 micro-cutaneous branches were extended and consistent with the nearby skin cutaneous branches. \u0000 \u0000 \u0000Conclusion \u0000The distal segment of the second dorsal metacarpal artery and the dorsal digital artery is anatomically constant. The distal segment of the second dorsal metacarpal artery and dorsal digital artery are the pedicle for the design of the bilobed flap of middle finger and index finger to repair small soft tissue defect on the thumb and purlicue. \u0000 \u0000 \u0000Key words: \u0000Second dorsal metacarpal artery; Finger web artery; Dorsal digital artery; Bilobed flap; Applied anatomy","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"562-565"},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42715039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
3D-CTA assisted anterolateral thigh lobulated perforator flap in repairing soft tissue defect of limb: 11 cases report 3D-CTA辅助股前外侧分叶穿支皮瓣修复四肢软组织缺损11例报告
中华显微外科杂志 Pub Date : 2019-12-25 DOI: 10.3760/CMA.J.ISSN.1001-2036.2019.06.008
Zhang Dexi, Z. Guohui, Zheng Guangcheng, Wang Yuanzheng, Song Kewei, Sun Luwei
{"title":"3D-CTA assisted anterolateral thigh lobulated perforator flap in repairing soft tissue defect of limb: 11 cases report","authors":"Zhang Dexi, Z. Guohui, Zheng Guangcheng, Wang Yuanzheng, Song Kewei, Sun Luwei","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.06.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.06.008","url":null,"abstract":"Objective \u0000To investigate the effectiveness of preoperative 3D-CTA in assisting the preparation of free thinned anterolateral thigh lobulated perforator flap with nerve in repairing soft tissue defect of limb. \u0000 \u0000 \u0000Methods \u0000Between February, 2010 and May, 2018, free super-thin anterolateral thigh lobulated perforator flap with nerve was transferred to repair soft tissue defect of limbs in 11 cases. There were 8 males and 3 females with an average age of 35 (range, 22-56) years. The defect area was 8.0 cm×11.0 cm-9.0 cm×23.0 cm. Preoperation CT scan of the free flap donor site was performed to obtain 3D images of the region with arterial blood supply by digital 3D reconstruction CT, and to determine the origin, direction, classification, length, diameter and the position of pedicle perforator. Postoperative regular followed-up was carried according to the Upper Limb Function Evaluation Trial Standards of Chinese Medical Association of Hand Surgery and Enneking Evaluation System. \u0000 \u0000 \u0000Results \u0000All 11 flaps survived. No vascular crisis happened. All 11 cases were followed-up for 3 to 12 (average, 5) months. The flaps were supple and elastic with near normal color. There was no bulkiness. Sensory function was recovered well and two point discrimination was 3.0-6.0 mm. According to the Upper Limb Function Evaluation of Upper Limb of Chinese Medical Association of Hand Surgery, the results were excellent in 1 case, good in 3 cases and fair in 1 case. The Enneking system was used to assesse the lower limbs recovery. The average score was 21, an average of 70% of limb function restored. \u0000 \u0000 \u0000Conclusion \u0000The free super-thin anterolateral thigh lobulated perforator flap with nerve offers advantages to the traditional anterolateral thigh flap. The survived flaps are ideal in terms of covering limb defects and restoring functions. Preoperative 3D-CTA in the anterolateral thigh perforator flap transplantation is an accurate and useful method. It helps a safer and successful operation with optimal outcome. \u0000 \u0000 \u0000Key words: \u00003D-CTA; Anterolateral thigh perforator flap; Lobulated flap; Repair; Limb","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"548-552"},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44670004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transplantation of free fibula composite tissue flap to repair bone and soft tissue defect after open fracture of proximal tibial 游离腓骨复合组织瓣移植修复胫骨近端开放性骨折后骨及软组织缺损
中华显微外科杂志 Pub Date : 2019-12-25 DOI: 10.3760/CMA.J.ISSN.1001-2036.2019.06.007
L. Zhong, Guo Yongming, Jiao Jian, Teng Yunsheng, Zhang Chao, Shi Yu, Wu Ke
{"title":"Transplantation of free fibula composite tissue flap to repair bone and soft tissue defect after open fracture of proximal tibial","authors":"L. Zhong, Guo Yongming, Jiao Jian, Teng Yunsheng, Zhang Chao, Shi Yu, Wu Ke","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.06.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.06.007","url":null,"abstract":"Objective \u0000To explore the clinical application and effect of free fibula composite tissue flap trans-plantation to repair bone and soft tissue defect after open fracture of proximal tibial. \u0000 \u0000 \u0000Methods \u0000From June, 2012 to June, 2018, free fibula composite tissue flap transplantations were applied to repair bone and soft tissue defect after open fracture of proximal tibial in 11 cases. Of the 11 cases, there were 10 males and 1 female(their ages ranged from 32 to 56, 36 on average); Six cases were caused by traffic accident, and 5 by crash. There were 3 fresh wounds and 8 chronic and infective wounds. Free fibular flaps were used in 7 cases, and free fibular flexor hallucis myocutaneous flaps were used in 4 cases. The fibular length with transplantation was 7-18 cm. The area of flaps or muscle flaps was ranged from 4 cm×8 cm to 8 cm×20 cm. Bone fracture healing was observed at 3, 6 and 12 months after operation. The function of injured extremity was evaluated in 1 year after surgical operation. \u0000 \u0000 \u0000Results \u0000All were successfully repaired, and composite tissue flaps survived. Of which, 10 wounds healed by first intention, and 1 wound healed by secondary intention, with the healing time of 12-18 days. All 11 cases were followed-up. The mean followed-up time was 18 months. The bone healing time ranged from 6 to 9 months (7 months on average). The Enneking Score System was applied to evaluate the leg function. Of the 11 cases, the mean scores was 25 (ranged from 22 to 27). The donor sites were not found malfunctional. \u0000 \u0000 \u0000Conclusion \u0000Transplantation of free fibula composite tissue flap can reduce the treatment time with good mechanical strength. It is an ideal method to repair bone and soft tissue defect after open fracture of proximal tibial. \u0000 \u0000 \u0000Key words: \u0000Fibula composite tissue flap; Fracture of tibial; Open fracture; Microsurgical technique","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"544-547"},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43500664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The replantation of penetrating severed finger with disconnected micro tissue blocks in 16 cases 显微组织块断指再植16例
中华显微外科杂志 Pub Date : 2019-12-25 DOI: 10.3760/CMA.J.ISSN.1001-2036.2019.06.004
J. Song, M. Guo, Jing-liang Zhang, Z. Ren, Zengyun Liu, Zhongming Huang, Qiao-hong Guo
{"title":"The replantation of penetrating severed finger with disconnected micro tissue blocks in 16 cases","authors":"J. Song, M. Guo, Jing-liang Zhang, Z. Ren, Zengyun Liu, Zhongming Huang, Qiao-hong Guo","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.06.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.06.004","url":null,"abstract":"Objective \u0000To explore the method of replanting severed piercing finger micro tissue blocks. \u0000 \u0000 \u0000Methods \u0000From February, 2001 to October, 2016, 16 cases of severed piercing finger micro tissue blocks were replanted with debridement. The trunk or branch of proper palmar digital artery was anastomosed. Vascular collocations were used such as venous arterialization when there was no anastomotic artery available. Regular postoperative followed-up was performed to observe the recovery of tissue survival, appearance, sensation of flap, and joint function. \u0000 \u0000 \u0000Results \u0000One case had partial epidermal necrosis, and healed after change of dressing. The finger-disconnected micro tissue blocks of other 15 cases survived well. After 6 months to 2 years of follow-up, the replanted micro tissue blocks were ruddy in color and recovered from S3 to S4. The appearance of the 16 fingers was good, and the function of joints was restored. \u0000 \u0000 \u0000Conclusion \u0000The finger-disconnected micro tissue blocks should be actively replanted. With skilled microsurgical techniques, the anastomosis of the arterial or venous artery will ensure the success of replantation and survived, as well as to restore good function and appearance. \u0000 \u0000 \u0000Key words: \u0000Penetrating severed finger; Micro tissue block; Precise repair; Replantation","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"533-535"},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43894501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Clinical efficacy of dorsal digital nerve fasciocutaneous pedicle flap with superficial vein anastomosis in repair of the type III and type IV of fingertip defects 指背神经筋膜皮蒂皮瓣结合浅静脉吻合术修复指端III型、IV型缺损的临床疗效
中华显微外科杂志 Pub Date : 2019-12-25 DOI: 10.3760/CMA.J.ISSN.1001-2036.2019.06.003
Liang Guo, Xuejun Wu, Jingui Lin
{"title":"Clinical efficacy of dorsal digital nerve fasciocutaneous pedicle flap with superficial vein anastomosis in repair of the type III and type IV of fingertip defects","authors":"Liang Guo, Xuejun Wu, Jingui Lin","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.06.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.06.003","url":null,"abstract":"Objective \u0000To analysis the clinical efficacy of dorsal digital nerves fasciocutaneous pedicle flap (DDNFPF) with superficial vein anastomosis in the treatment of the type III and type IV of fingertip defect, and the relationship between the incidence of vein crisis and superficial vein anastomosis. \u0000 \u0000 \u0000Methods \u0000A total of 85 patients with 92 fingers, treated by DDNFPF from February, 2017 to December, 2018, were retrospectively analyzed. The superficial veins of 30 patients with 32 fingers were anastomosed, and 55 patients with 60 fingers were not. The difference of the superior rate and the incidence of venous crisis between superficial vein anastomosis and non-superficial vein anastomosis was compared by Chi-square test. The difference was considered as statistically significant when P<0.05. The regular postoperative followed-up was performed. \u0000 \u0000 \u0000Results \u0000The average followed-up time was (7.0±2.9) months. The incidence of venous crisis in anastomosis group (1/32) was lower than that in non-anastomosis group (13/60). The difference was statistically significant (χ2=4.217, P 0.05) . The repaired fingertips of the 2 groups were in good appearance, wear-resistant, stable holders and two-point discrimination was 5 to 8 mm. \u0000 \u0000 \u0000Conclusion \u0000DDNFPF for the type III and IV type of fingertip defect is safe and effective. A anastomosis of superficial veins in recipient area can significantly reduce the incidence of venous crisis. \u0000 \u0000 \u0000Key words: \u0000Dorsal digital nerve fasciocutaneous pedicle flap; Fingertip defects; Superficial vein anastomosis; Venous crisis","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"528-532"},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69872107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical outcomes of contralateral 7th cervical nerve transfer in the treatment of total brachial plexus root avulsion in Xinjiang Autonomous Region 对侧颈7神经移植治疗全臂丛神经根撕脱伤在新疆地区的临床效果
中华显微外科杂志 Pub Date : 2019-12-25 DOI: 10.3760/CMA.J.ISSN.1001-2036.2019.06.006
Yushan Maimaiaili, P. Ren, Alike Yamuhanmode, Abulaiti Alimujiang, Abula Abulaiti
{"title":"Clinical outcomes of contralateral 7th cervical nerve transfer in the treatment of total brachial plexus root avulsion in Xinjiang Autonomous Region","authors":"Yushan Maimaiaili, P. Ren, Alike Yamuhanmode, Abulaiti Alimujiang, Abula Abulaiti","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.06.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.06.006","url":null,"abstract":"Objective \u0000To evaluate the long-term functional recovery after contralateral 7th cervical nerve(C7) transfer with brachial plexus root avulsion and the effect on the contralateral limbs after operation. \u0000 \u0000 \u0000Methods \u0000A total of 83 patients with injory of brachial plexus avulsion were underwent contralateral C7 transfer from September, 2004 to December, 2014. Among them, contralateral C7 were transferred to the median nerve in 33 cases, to radial nerve in 14 cases, to musculocutaneous nerve in 22 cases, and simultaneous transfer to median and musculocutaneous nerve in 14 cases. The followed-up contents included recovery of muscular strength and sensory innervated by the recipient nerve, bilateral limbs synergistic activity and the effect on the contralateral limbs after the surgery. \u0000 \u0000 \u0000Results \u0000All 83 cases were successfully followed-up for 3.2-6.2 years (average, 4.5 years), and found no significant effect on function of the contralateral limbs. In the group of C7 transferred to the median nerve group, 10 cases had muscle strength recovered≥M3, and 26 cases had sensory recovered≥S3; In the group of C7 transferred to the radial nerve, 6 cases had muscle strength recovered≥M3, and 9 cases had sensory recovered ≥S3; In the group of C7 transferred to the musculocutaneous nerve, 12 cases had muscle strength recovered≥M3, and 17 cases had sensory recovered≥S3. In the group of C7 simultaneous transferred to the median and musculocutaneous nerve, 6 cases had muscle strength of wrist and digital flexion recovered≥M3, 5 cases had elbow flexion recovered≥M3, 9 and 10 cases had sensory of innervated area and lateral forearm region recovered≥S3, respectively. \u0000 \u0000 \u0000Conclusion \u0000Contralateral C7 transfer is an ideal procedure for the treatment of total brachial plexus root avulsion with definitive clinical outcomes. \u0000 \u0000 \u0000Key words: \u0000Brachial plexus root avulsion; Seventh cervical nerve; Nerve transfer; Limb coordination","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"540-543"},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48309180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neuronavigation-assisted microsurgical operation via keyhole approaches for distal intracranial artery aneurysms 锁眼入路神经导航辅助显微外科手术治疗颅内远端动脉瘤
中华显微外科杂志 Pub Date : 2019-12-25 DOI: 10.3760/CMA.J.ISSN.1001-2036.2019.06.009
C. Dai, Ailin Chen, Chao Sun, Tao Wu, Qing Zhu
{"title":"Neuronavigation-assisted microsurgical operation via keyhole approaches for distal intracranial artery aneurysms","authors":"C. Dai, Ailin Chen, Chao Sun, Tao Wu, Qing Zhu","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.06.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.06.009","url":null,"abstract":"Objective \u0000To investigate the value of neuronavigation system in the keyhole microsurgical operation for distal intracranial artery aneurysms(DIAA). \u0000 \u0000 \u0000Methods \u0000The clinical data of 16 cases with DIAA who were treated by via keyhole approaches, from January, 2013 to December, 2018, were analyzed retrospectively. Ten aneurysms located in anterior cerebral artery(ACA), 3 in posterior inferior cerebellum artery(PICA) and 3 in perforator artery(PA). The optimal skin incision and craniotomy were designed with assistence of neuronavigation system preoperatively, and lesions were located precisely under the guidance of neuronavigation system during microsurgery before clipping or resection. Angiography was performed before discharge, and clinic followed-up was conducted monthly till 6 months after surgery. \u0000 \u0000 \u0000Results \u0000The systematic error of neuronavigation system ranged from 0.5 mm to 1.0 mm, with an average of 0.6 mm. All 16 aneurysms were explored and managed successfully with the guidance of neuronavigation system without aneurysm premature rupture nor neuronavigation-related complications. Absolute occlusion of all aneurysms was documented angiographically after surgery. Of all cases, 2 experienced shunt procedure due to delayed hydrocephalus. During 6 months follow-up period, all 16 cases recovered well. \u0000 \u0000 \u0000Conclusion \u0000Neuronavigation system can precisely locate the deep-seated DIAA, contribute to the preoperative planning of microsurgery via keyhole approaches and avoid evitable injury during excessive manipulation. The noninvasive, rapid and contrast-enhanced CT images of head was an ideal data source for the neuronavigation system. \u0000 \u0000 \u0000Key words: \u0000Intracranial aneurysm; Surgical approach; Keyhole; Neuronavigation; Microsurgical operation","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"553-556"},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44492634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reconstruction of thumb defect by transplanting second toe combined with hallucis flap: 9 cases report 第二足趾移植联合拇皮瓣修复拇指缺损9例报告
中华显微外科杂志 Pub Date : 2019-12-25 DOI: 10.3760/CMA.J.ISSN.1001-2036.2019.06.002
Q. Tan, Yao-sheng Li, Yongqiang Zhang, Qian Wang, Zhen Li, Lei Yang
{"title":"Reconstruction of thumb defect by transplanting second toe combined with hallucis flap: 9 cases report","authors":"Q. Tan, Yao-sheng Li, Yongqiang Zhang, Qian Wang, Zhen Li, Lei Yang","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.06.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.06.002","url":null,"abstract":"Objective \u0000To introduce the method for reconstruction of thumb defect by transplanting free flap of second toe combined with the hallucis flap. \u0000 \u0000 \u0000Methods \u0000From June, 2012 to February, 2017, a total of 9 cases of thumb defect were treated. The average age of these 9 patients was 26 years. The plane of thumb defect was class II area A to class III area A. According to the condition of thumb defect, designed the incision on the hallux and the second toe of the contralateral foot, and cut the 2nd digit and big-toe nail flap with a common arterial trunk. The nail of hallucis flap was rotated 90 degree and connected to the distal end of the 2nd toe. The hallucis flap covered the narrow neck of the 2nd toe. Thus, the circumference of the reconstructed finger and the length of the toenail were increased. Regular followed-up was made after operation. \u0000 \u0000 \u0000Results \u0000All 9 transplantation flaps survived, and donor sites healed primarily. Postoperative followed-up period ranged from 4 to 12 (averge,7) months. All the reconstructed thumbs survived and donor toes were in satisfactory appearances. According to the Functional Assessment Criteria of the Upper Limb Formulated by the Hand Surgery Society of Chinese Medical Association, the outcomes were graded as excellent in 6 cases and good in 3 cases. All the patients were able to manage their daily activities independently. Donor toe injury was small, and their shape and function was good. \u0000 \u0000 \u0000Conclusion \u0000Free flap of second toe combined with hallucis can effectively improve the appearance of the reconstructed thumb. The appearance of the reconstructed thumb is symmetrical, beautiful, and the function is good. \u0000 \u0000 \u0000Key words: \u0000Thumb reconstruction; Second toe; Hallucis flap; Tissue transplantation; Thumb defect","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"524-527"},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45361049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Microsurgical treatment of the plexiform neurofibroma in the forearm and palm 前臂及手掌丛状神经纤维瘤的显微外科治疗
中华显微外科杂志 Pub Date : 2019-10-25 DOI: 10.3760/CMA.J.ISSN.1001-2036.2019.05.006
Yang Li, Yuehua Liu, C. Bai, J. Teng, Tenglong Hu, Li Song, Ming-wu Zhou
{"title":"Microsurgical treatment of the plexiform neurofibroma in the forearm and palm","authors":"Yang Li, Yuehua Liu, C. Bai, J. Teng, Tenglong Hu, Li Song, Ming-wu Zhou","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.05.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.05.006","url":null,"abstract":"Objective \u0000To explore the clinical effect of microsurgery in the treatment of the tumor which was diagnosed with the plexiform neurofibroma (PN) of the forearm and palm. \u0000 \u0000 \u0000Methods \u0000From January, 2014 to June, 2017, 6 cases of the PN in the forearm and palm were removed by microsurgery such as neurovascular transplantation, separation and anastomosis under microscope, etc. There were 4 males and 2 females, with an average age of 9.2 (range, 2-18) years. There was 1 case with PN of the median nerve, ulnar nerve and their branches in the right forearm and palm, 2 cases with PN of the median nerve and its branches in the right forearm and palm, 2 cases with PN of the median nerve and its branches in the left forearm and palm, and 1 case with PN of the ulnar nerve and its branches in the left forearm and palm. The postoperative function and feeling of the patients were evaluated by outpatient followed-up. \u0000 \u0000 \u0000Results \u0000The pathological results of 6 patients all showed PN, and their incisions healed primarily. The patients were followed-up for 6 to 36 months, with an average of 18 months. No obvious scar formation was observed in all incisions. Among them, PN of the palmar of the youngest patient recurred after the operation, and it was resected in a second operation. The remaining 5 patients had no recurrence during follow-up. The 2 point resolution of each fingertip of the affected limb of the patients who had median and ulnar PN was 2-5 mm, with an average of 3.30 mm; the 2 point resolution of the thumb, indicator, middle and ring fingers of the affected limbs of the patients who had median PN was 2-5 mm, with an average of 2.95 mm; the 2 point resolution of the ring and little fingers of the affected limbs of the patients who had ulnar PN was 3-4 mm, with an average of 3.50 mm. According to the related evaluation criteria made by the American Orthopedic Foot and Ankle Surgery Society (AOFAS) , the results of the forearm and hand functions were excellent in 5 cases, good in 1 case. \u0000 \u0000 \u0000Conclusion \u0000The application of microsurgical techniques in the treatment of PN in the forearm and palm can be effective separation of tumor and nerve fibers, effectively protect the branches of the median nerve and ulnar nerve and their blood circulation, prevent recurrence and reduce nerve damage after operation. \u0000 \u0000 \u0000Key words: \u0000Forearm; Palm; Plexiform neurofibroma; Median nerve; Ulnar nerve; Microsurgical technique","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"442-445"},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45814547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Orthopaedic robot-assisted free vascularised fibular grafting for the treatment of avascular necrosis of the femoral head 骨科机器人辅助游离带血管腓骨移植术治疗股骨头缺血性坏死
中华显微外科杂志 Pub Date : 2019-10-25 DOI: 10.3760/CMA.J.ISSN.1001-2036.2019.05.002
Shanlin Chen, Y. Rong, He-Jia Miao, Lu Liu, Yun-hao Xue, Pengcheng Li, Jingheng Wu, D. Tong
{"title":"Orthopaedic robot-assisted free vascularised fibular grafting for the treatment of avascular necrosis of the femoral head","authors":"Shanlin Chen, Y. Rong, He-Jia Miao, Lu Liu, Yun-hao Xue, Pengcheng Li, Jingheng Wu, D. Tong","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.05.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.05.002","url":null,"abstract":"Objective \u0000To introduce the surgical procedure of orthopaedic robot-assisted vascularised fibular grafting for the treatment of ANFH and report the short-term result. \u0000 \u0000 \u0000Methods \u0000From September, 2016 to November, 2018, 17 patients (21 hips) with ANFH had undergone robot-assisted free fibular grafting. There were 14 males and 3 females, of which, 8 cases were associated with the right side, 5 cases the left side, and 4 cases with both sides. The average age was 35 (ranged from 17 to 55) years. There were 7 patients suffered from idiopathic ischemic necrosis of femoral head, 4 patients who had cannulated screws fixed after a femoral neck fracture, 4 patients who had a history of alcohol consumption, 1 patient who had taken corticosteroids for 6 months to treat nephritis, and 1 patient who had a history of alcohol consumption and had also taken corticosteroids. Seventeen hips were in Ficat stage II, and 4 hips were in Ficat stage III. The orthopaedic surgical robot workstation was used to plan the entry point and target of the guide pin during the operation, to place a cannula in the optimal position. Then a bone window was created and the fibula was placed into the bone tunnel. Using fluoroscopy to monitor each step of the procedure and verify the position of the fibula. Finally, the vessels were anastomosed. The patient remain in bed completely for a week with the use of vasodilator. The follow-up was accomplished with phone call and outpatient clinic, and Harris score was evaluated. \u0000 \u0000 \u0000Results \u0000All 21 surgical procedures were successful. The guide pins and fibula were accurately placed according to the robot’s plan, and the tips of the fibula were placed at the centre of the load-bearing region of the femoral heads, 4 to 6 mm from the articular surface. Conventional anticoagulant, anti-infective therapy was performed after the procedure. Ten patients were followed-up postoperatively more than 1 year, with an average of 15 (from 12 to 24) months. The function of the hip joint recovered smoothly for 9 patients. Frontal and lateral X-ray and CT scans showed that the tips of the fibula were placed at the centre of the load-bearing region, 4 to 6 mm from the articular surface. One patient suffered from bilateral femoral head necrosis and the right side recovered smoothly after operation. However, joint movement was restricted for the left hip and the pain was significant. An arthroscopic examination was performed 1 month after the operation and did not identify any problems such as intraarticular incular infection or articular surface of the femoral head was protruded by the tip of the fibula. The symptoms were alleviated after removing the osteophytes at the rim of the acetabulum. The Harris score was 62.4±13.6 before operation, and 84.5±4.5 at the last time of followed-up after operation. The difference in Harris scores was statisticly significant (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000With the assistance of an orthopaedic robot system, the guide pin can be","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"423-428"},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46317996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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