中华显微外科杂志最新文献

{"title":"Digital assisted chimeric deep circumflex iliac artery perforator flap in the reconstruction of mandibular composite defects","authors":"Z. Zhan, S. Liao, Yong-feng Chen, T. Gao, Xiaoying Du, Liang Liu, Dongkun Yang, Songtao Yu","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.05.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.05.003","url":null,"abstract":"Objective \u0000To evaluate the clinical effect of digital assisted chimeric deep circumflex iliac artery perforator flap(DCIAPF) in the reconstruction of mandibular composite defects. \u0000 \u0000 \u0000Methods \u0000From January, 2018 to January, 2019, 6 cases of mandibular tumor patients with postoperative defect within side were treated. Preoperative CTA was used to evaluate the deep branches of spin iliac artery. Digital simulation software and 3D printing technology was taken, vascularized iliac flap of the design guide of bone was made, and the rebuilding effect was simulated. DCIAPF was used to repair the defect of lower jawbone. The donor sites were sutured directly. The patients were followed-up in outpatient department for 3-6 months to evaluate the recovery of the patient's shape, jaw height and occlusal function, as well as the complications in the donor area. \u0000 \u0000 \u0000Results \u0000Postoperation pathological examination results: ameloblastoma in 2 cases, 4 cases of gingival cancer. The length of cut out ilium was 6.0-13.0 cm, carrying the flap area of 3.0 cm×1.0 cm-6.0 cm×5.0 cm. Six cases of DCIAPF and iliac bone flap survived. The shape, mandibular height and occlusal function were satisfactory. And no obvious complications were found in the donor area. \u0000 \u0000 \u0000Conclusion \u0000The blood supply of DCIAPF is rich with enough bone mass and height. The position of terminal skin perforators is invariant. The complications of donor sites is less. With the help of digital technology, the accuracy of mandibular defect repair and the 3-dimensional wound repair can be realized, and provides an advantage condition for subsequent dental implant. It is one of the ideal method of reconstruction of mandibular defect. \u0000 \u0000 \u0000Key words: \u0000Deep circumflex iliac artery; Chimeric flap, perforator flap; Digital technology; Mandibular defect; Reconstruction","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"429-433"},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47830900","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}

{"title":"Application of enhanced recovery after surgery principles in treating long bone defect with free fibula graft","authors":"Z. Wang, Aixi Yu, Baiwen Qi, Weidong Xiao, Yong Zhao, Zonghuan Li","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.05.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.05.011","url":null,"abstract":"Objective \u0000To summarize the application of enhanced recovery after surgery (ERAS) principles in treating long bone defect with free fibula graft (FVFG) . \u0000 \u0000 \u0000Methods \u0000From January, 2012 to January, 2017, ERAS principles were applied in 26 cases of long bone defect treating with vascularized fibula flap graft, via a series of comprehensive measures, including strengthening psychological nursing, nutrition support and pain management, optimizing operation plan, and early scientific functional exercise. Surgical duration, hospital stay time, satisfaction of patients, postoperative visual analogue scale (VAS) score, bone defect healing time, and Enneking score were recorded through regular outpatient follow-up after discharge. \u0000 \u0000 \u0000Results \u0000The average length of surgical duration and hospital stay time was (3.2±0.5) h and (10.2±1.2) d, respectively. Discharged satisfaction was greater than 95%. Postoperative VAS score was less than 3. During the follow-up period of 1.6-6.0 years, 26 fibular flap survived, and all the bone defect were healed, with an average healing time of (5.5±0.6) months. Followed-up at 1.5 years after the operation, the upper limb function of 7 patients increased by 80.1%, and the lower limb function of 19 patients increased by 82.5%. \u0000 \u0000 \u0000Conclusion \u0000The application of ERAS in treating long bone defect with FVFG can obtain satisfactory limb function, alleviate patients’ pain, shorten the duration of hospitalization, promote the rehabilitation and satisfaction of patients. \u0000 \u0000 \u0000Key words: \u0000Enhanced recovery after surgery; Fibula flap; Graft; Bone defect, long","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"463-466"},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46616260","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}

{"title":"Transplantation of lobulated free latissimus dorsi flap for repairing irregular soft tissue defect of shank","authors":"Y. Shao, Wei Lin, Jianjiang Liu, Wenjun He, Weixin Chen, Ke Li, G. Shen","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.05.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.05.008","url":null,"abstract":"Objective \u0000To investigate the feasibility and clinical effects of lobulated free latissimus dorsi flap in repairing severe shank trauma with irregular soft tissue defect. \u0000 \u0000 \u0000Methods \u0000Eight patients with soft tissue defect of shank due to trauma were treated from February, 2013 to November, 2018, which were 5 males and 3 females. All wounds were irregular. The size of soft tissue defect ranged from 11.0 cm×15.0 cm to 15.0 cm×23.0 cm, with different degrees exposure of deep tissue such as bone and tendon. Five cases out of 8 were infected wound, 3 cases of which had internal fixation bracket exposed. Five infected wounds were firstly treated with negative pressure after debridement, then repaired with flap transplantation until the infection were completely controlled. Other wounds were repaired directly after debridement. The free lobulated latissimus dorsi flap was designed and applied to repair the irregular soft tissue defect of shank. The lobulated latissimus dorsi flap with the outer branch of the thoracodorsal artery ranged from 14.0 cm×7.0 cm to 24.0 cm×8.5 cm. The lobulated latissimus dorsi flap with the inner branch of the thoracodorsal artery ranged from 10.0 cm×5.0 cm to 15.0 cm×7.0 cm. When cutting the flap, the branch vessels should be protected to insure the continuity of the thoracodorsal artery. After spliced the 2 lobulated flaps, the thoracodorsal arteriovenous was anastomosed with the recipient region arteriovenous. All the donor sites were sutured directly. All patients were followed-up by outpatient and telephone regularly. \u0000 \u0000 \u0000Results \u0000Seven flaps survived well. Only 1 case of partial necrosis appeared at the distal edge of the lobulated flap and healed after wound care. All patients were followed-up from 3 to 30 months, averaged of 14 months. The texture of flap was flexible and the appearance was well. Only a linear scar was left in the donor site. The shoulder joint retained good mobility. \u0000 \u0000 \u0000Conclusion \u0000The lobulated latissimus dorsi flap has rich blood supply, concealed donor area and high survival rate after transplantation, which can flexibly repair the irregular soft tissue defect of the shank, and effectively prettify the appearance of the recipient area. This strategy has little effect on the appearance and function of the donor area, and worthy of promoting in clinic. \u0000 \u0000 \u0000Key words: \u0000Lobulated, latissimus dorsi flap; Transplantation; Shank; Microsurgical technique","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"450-454"},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46024130","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}

{"title":"Clinical application of the technology of supercharging and making flap in Yamano area I type II replantation of broken finger","authors":"Liping Guo, J. Ju, Kai Wang, G. Jin","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.05.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.05.009","url":null,"abstract":"Objective \u0000To investigate the clinical efficacy of the use of the technology of supercharging and making flap on Yamano area I type II replantation of broken finger. \u0000 \u0000 \u0000Methods \u0000From January, 2016 to June, 2018, 15 cases (16 fingers) of type II replantation of severed fingers in Yamano area I were treated. During the operation, 2 arteries in the severed fingers were anastomosed and supercharged outside the arteries. Bone fragments in the severed fingers were removed to make them flaps. The blood supply and long-term healing of replanted finger were observed after routine treatment including antiinfection, anticoagulation and antispasm in outpatient follow-up. \u0000 \u0000 \u0000Results \u0000Sixteen fingers of replantation of severed fingers survived smoothly. Followed-up for 6-12 months showed that there were no deformities in the surviving finger, good nail growth, full abdomen and recovery of pain and temperature. The static 2-PD was 7-9 mm. According to the Evaluation Criteria of Replantation Function of Severed Finger of Chinese Medical Association Hand Surgery Society, 13 fingers were excellent and 3 fingers were good. \u0000 \u0000 \u0000Conclusion \u0000In the replantation of Yamano area I type II amputated finger, high survival rate and good healing effect can be achieved by using the technology of supercharging and making flap. \u0000 \u0000 \u0000Key words: \u0000Replantation of broken finger; Yamano I area; Supercharging; Making flap","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"455-458"},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43060939","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}

{"title":"Microscopic anatomy study of artery of auricle for auricle replantation","authors":"Xianfeng Hua, Peng-cheng Liu, Qinghao Zhao, Z. Ding, Chunbo Yu","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.05.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.05.013","url":null,"abstract":"Objective \u0000To provide the anatomical information for auricle replantation. \u0000 \u0000 \u0000Methods \u0000From March, 2016 to March, 2019, a total of 25 fresh adult cadaveric head were used, 20 of these specimens were perfused with plastic and eroded to be vascular cast mold, 5 specimens perfused with red latex for anatomy, then observed the origin, course, diameter and arteries anastomose between branches of the posterior auricular artery (PAA) and superficial temporal artery (STA). \u0000 \u0000 \u0000Results \u0000The main blood supply to the auricle were auricle branches of PAA and STA. The auricle branches of PAA and STA both divided into superior, intermedius and inferior branches, and distributed in the auricle posterior surface and anterior surface, respectively. The auricle branches of PAA running across ear cartilage, distributed in the anterior surface, and anastomosed with auricle branches of STA. The diameters of these branches at the initiating portion were 0.2-0.8 mm. Eighty percent of blood supply to earlobe was from the inferior branches of PAA, and 20% from the STA. \u0000 \u0000 \u0000Conclusion \u0000The auricle branches of PAA played an important role to the auricle replantation. The auricle branches of PAA should be the firstly selected vessle in operation, and the auricle branches of STA be the second choice. \u0000 \u0000 \u0000Key words: \u0000Posterior auricular artery; Superficial temporal artery; Auricle replantation; Microscopic anatomy","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"473-476"},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45670201","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}

{"title":"Repair of electrical wound injury in upper limbs with perforator flap pedicled with the descending branch of lateral circumflex femoral artery","authors":"Pengjun Sun, J. Zhan, Sixia Wang, Jinsheng Wu","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.05.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.05.007","url":null,"abstract":"Objective \u0000To investigate the clinical effect of repairing the electrical wound of upper limbs by using the perforator flap pedicled with the descending branch of lateral circumflex femoral artery. \u0000 \u0000 \u0000Methods \u0000From August, 2014 to July, 2018, the perforator flap pedicled with the descending branch of lateral circumflex femoral artery was used to repair the electrical wound of the upper limbs in 10 cases (11 sides), which were 9 cases (10 sides) in males, 1 case (1 side) in female. Three cases in the left side, 6 cases in the right side, and 1 case in both sides. The area of the flap was 12 cm ×6 cm-26 cm ×11 cm. The arterial, venous and cutaneous nerves of the perforator flap were anastomosed with those of the recipient area, respectively. The patients were followed-up in outpatient depatment, including flap survival, texture, appearance, sensory recovery, donor site healing and scar hyperplasia. \u0000 \u0000 \u0000Results \u0000All the flaps survived without vascular crisis. Infection occurred in 1 case (1 side). The wound was healed 19 d after the operation by using effective antibiotics and dressing change. All cases were followed-up for 4-24 months after the operation. The blood supply of the flaps was good, the texture was similar to that of the recipient area, and the appearance was satisfactory. There was no obvious bloat, and no ulceration of the flap was found. The anterolateral femoral cutaneous nerve was retained in the flap and anastomosed with the cutaneous nerve in the recipient area. The sensory recover to S3 in 3 flaps, S2 in 7 flaps, S1 in 1 flap. The donor site of the flap was sewn up with aesthetic treatment. After the operation, the donor sites presented a linear scar with a concealed position and no occurrence of osteofascial compartment syndrome. \u0000 \u0000 \u0000Conclusion \u0000The perforator flap pedicled with the descending branch of lateral circumflex femoral artery has a constant anatomical position of perforator vessel, a wide excision range, abundant blood supply, a good appearance and a hidden donor site, which is a good choice for repairing the electrical wound. \u0000 \u0000 \u0000Key words: \u0000Electrical injury; Descending branch, lateral circumflex femoral artery; Perforator flap; Upper limb","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"446-449"},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49459396","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}

{"title":"The preliminary application of 3-dimensional visual technique without eyepiece in repairing breast defect after radical mastectomy in 2 cases of breast cancer","authors":"L. Mu, Yan Liu, Ye Bi, Huiran Zang, Saisai Cao, Hui Tang, Yi Zhu, Yujie Chen, Kai Yang","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.05.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.05.004","url":null,"abstract":"Objective \u0000To investigate the possibility of microsurgical anastomosis of artery, vein and lymphatic vessel under 3-dimension screen without eyepiece. \u0000 \u0000 \u0000Methods \u0000During March, 2019, 2 cases (48 and 62 years old) were operated for breast reconstruction, chest wall deformity modified, and axillary scar contracture release, under 3-dimension screen without eyepiece. Deep epigastric artery perforators (artery and vein) dissections were carried on, and microsurgical anastomosis of artery, vein and lymphatic vessel were finished. Coupler was used to do the end-to-end anastomosis of veins (2.5 mm), interrupted suture end-to-end anastomosis with 9-0 nylon for artery (2.0 mm). Reverse arm lymphatic dynamic fluorescence methylene blue tracer under Near Infrared Imaging was used to test the function of lymphatic system. The ends of 2 dominant drainage lymphatic vessels was found in the released axillary area (0.2 mm and 0.3 mm, respectively) , and were anastomosis to the vein (0.5 mm) of lateral chest lymphatic tissue. Immediate methylene blue tracer under near infrared imaging was used to confirm the patency of lymphatic vessels-veins anastomosis and follow-up post operation. Flap were monitored use HHD. \u0000 \u0000 \u0000Results \u0000Two patients recovered well, and the flaps survived completely with appreciated appearances. The lymphedema of the arms were getting better, the peripheral diameter was reduced by about 2.0 cm compared with that before operation. \u0000 \u0000 \u0000Conclusion \u0000The technique of microsurgical anastomosis of artery, vein and lymphatic vessel without eyepiece under 3-dimension screen is possible and safe. \u0000 \u0000 \u0000Key words: \u0000Three-dimensional visual technique vessel(3-dimension screen); Without eyepiece; Breast reconstruction; Lymphedema; Microvascular anastomosis; Lymphatic vessel anastomosis","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"434-437"},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45627655","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}

{"title":"Using the posterior tibial artery and peroneal artery perforator flaps to repair heel wounds: 18 cases report","authors":"Yue-fei Liu, J. Ju, R. Zhou, Changqing Hu, Liangen Yang, Lucheng Chen, Qianheng Jin","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.04.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.04.002","url":null,"abstract":"Objective \u0000To investigate the clinical efficacy of using the posterior tibial artery and peroneal artery perforator flaps to repair the heel wounds. \u0000 \u0000 \u0000Methods \u0000From January, 2011 to May, 2018, heel soft tissue defect caused by trauma in 18 cases were treated by posterior tibial artery and peroneal artery perforator flaps respectively. The posterior tibial artery perforator flap was used in 11 cases, and the peroneal artery perforator flap was used in 7 cases. The area of flaps ranged from 5.0 cm×3.0 cm to 11.0 cm×9.0 cm. The length of the vascular pedicle was from 10.0 cm to 16.0 cm. After operation, the patients were followed-up regularly. The time of wound healing, appearance and texture of the flap, and function of ankle joint were observed. \u0000 \u0000 \u0000Results \u0000After the operation, 13 flaps survived uneventfully. The wound achieved primary healing. Partial necrosis occurred in the distal of posterior tibial artery perforator flap in 2 cases, and repaired by skin graft 1 or 2 months later. Marginal necrosis occurred in posterior tibial artery perforator flap in 2 cases and in peroneal artery perforator flap in 1 case. And scar healing occurred in these 3 cases finally. All the 18 patients were followed-up for 3 to 60 months, with an average of 10 months. Fracture healing time was from 3-6 months, with an average of 4 months. Flap was soft with satisfied appearance in 16 cases. Obvious scar formation occurred in 2 cases. There was no obvious scar contracture in donor sites. There was no obvious limitation of the flexion and extension function of the ankle joint in 18 cases. According to the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, there was excellent in 16 cases, and good in 2 cases. \u0000 \u0000 \u0000Conclusion \u0000As for the characteristics of the heel wound, it is a simple and practical method to use leg perforator flap to repair. The flap is based on a long vascular pedicle. And the clinical effect is satisfied. \u0000 \u0000 \u0000Key words: \u0000Posterior tibial artery; Peroneal artery; Perforator flap; Heel; Repair","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"317-321"},"PeriodicalIF":0.0,"publicationDate":"2019-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44671961","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}

{"title":"Repairation of composite distal soft tissue defect of thumb and finger with mini toenail flap","authors":"Fei-ya Zhou, Liang-fu Jiang, Xian Zhang, Weiyang Gao, Yong-huan Song, Jian Ding","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.04.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.04.003","url":null,"abstract":"Objective \u0000To introduce the repairation procedure of composite distal soft tissue defect of thumb and finger with mini toenail flap. \u0000 \u0000 \u0000Methods \u0000From June, 2015 to June, 2018, 7 cases with composite tissue defect at 7 distal fingers, including 5 thumbs, 1 index finger and 1 middle finger, were reconstructed with mini toenail flap transfer. The flap sizes which were raised during the operation ranged from 4.5 cm×3.0 cm-3.0 cm×1.5 cm. The donor sites were covered by toe phalanx shortening, V-Y advancement flap and local pedicle flap. Microsurgical routine treatment was made after the operation, and followed-up regularly. \u0000 \u0000 \u0000Results \u0000Seven flaps of 7 cases completely survived without any necrosis. All the wounds at the donor sites healed well. All patients were followed-up for 6-36 months. The motive, sensor and cosmetic result were satisfied. In sensory function, the two-point discrimination distance could restore to be 4-6 mm. \u0000 \u0000 \u0000Conclusion \u0000The mini toenail flap transfer is a reliable and suggested method. It can anatomically restored the distal digit sensor function with cosmetic contour, and regain the motive, sensory function and satisfied cosmetic appearance. \u0000 \u0000 \u0000Key words: \u0000Toenail flap; Toe transplantation; Finger; Repairation; Distal finger defect","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"322-325"},"PeriodicalIF":0.0,"publicationDate":"2019-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47962793","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}

{"title":"Free graft of vascularized iliac bone flap based on deep iliac circumflex vessels for the treatment of osteonecrosis of the femoral head","authors":"Ju-yu Tang, Wei Du, Panfeng Wu, Zheng-bing Zhou, Fang Yu, X. Pang, Lei Zeng, Ding Pan, Yongbing Xiao, Rui Liu, Li-ming Qing, Ou Qifeng, Xing Zhang","doi":"10.3760/CMA.J.ISSN.1001-2036.2019.04.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2019.04.001","url":null,"abstract":"Objective \u0000To investigate the feasibility and clinical efficacy of free graft of vascularized iliac bone flap based on deep iliac circumflex vessels for the treatment of osteonecrosis of femoral head (ONFH). \u0000 \u0000 \u0000Methods \u0000Twelve cases of ONFH (13 hips) received free graft of vascularized iliac bone flap based on deep iliac circumflex vessels from April, 2016 to July, 2017. The average Harris score was (74.7±6.9) in the second stage and (68.6±9.2) in the third stage. After debriding the necrosis bone of the femoral head, the contralateral vascularized iliac bone flap had been harvested, and then implanted into the femoral head. The deep iliac circumflex artery and its accompanying vein were anastomosed with the transverse branch (or ascending branch) of the lateral circumflex femoral artery and concomitant vein respectively. The herringbone brace was used for hip fixation for 3 weeks after operation. X-ray examination(1, 3, 6, 9 and 12 months after operation, respectively) and Harris hip score (6 and 12 months after operation, respectively) were performed to evaluate the recovery results of the femoral head. Scores were recorded and analyzed by paired t-test. The difference was considered to statistically significant if P<0.05. \u0000 \u0000 \u0000Results \u0000The patients were followed-up for 15 (12-20) months. The iliac bone flap of 12 patients (13 hips) healed well. There was no necrosis and collapse in 12 hips, except 1 femoral head collapsed slightly because of weight loading too early. The average Harris score was (91.6±4.5) of the second stage and (84.8±6.1) of the third stage. Compared with scores before the operation, the difference was statistically significant (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Free vascularized iliac bone grafting based on deep iliac circumflex vessels is an ideal treatment for ONFH head in middle and advanced stage. \u0000 \u0000 \u0000Key words: \u0000Osteonecrosis of the femoral head; Iliac bone flap; Deep iliac circumflex vessels; Transplantation; Harris hip score","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"42 1","pages":"313-316"},"PeriodicalIF":0.0,"publicationDate":"2019-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41567195","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}