中华显微外科杂志最新文献

{"title":"Application of self-made mini external fixator in phalangeal fractures","authors":"Z. Ye, Xia Lin, Hailong Ni, Daye Xiang, S. He","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.06.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.06.008","url":null,"abstract":"Objective \u0000To explore the clinical effect of phalangeal fractures with self-made mini external fixator. \u0000 \u0000 \u0000Methods \u0000From June, 2014 to June, 2017, 16 cases of phalangeal fracture were treated with self-made mini external fixator. In the followed-up periods, the regulating rechecks of X-ray and measurement of interphalangeal joint activity were determined. The total active movement (TAM), numerical pain ranting scale (NPRS) and morning stiffness was used to estimate the fracture healing and the hand function recovery. \u0000 \u0000 \u0000Results \u0000Pain and abnormal movement around fracture was found 6 weeks after the operation in 1 case, which had been healed by removing the external fixation, open reduction and internal fixation with kirschner wire. The other 15 cases were followed-up of 48-72 (average, 58) weeks. The fracture has healed. And there was no osteomyelitis, no breakage and loosening of steel needles. The clinical healing time of the fracture was 14 to 16 weeks, with an average of 15.5 weeks. According to the TAM, NPRS and morning stiffness, there was excellent in 11 cases, and good in 4 cases. \u0000 \u0000 \u0000Conclusion \u0000The self-made mini external fixator can maintain the stability after fracture reduction, provide the tension required for the healing of collateral ligament and joint capsule, and meet the need of early functional exercise. It is an ideal treatment option for phalangeal fractures. \u0000 \u0000 \u0000Key words: \u0000Phalangeal fracture; External fixator; Self-made; Repair","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"552-555"},"PeriodicalIF":0.0,"publicationDate":"2018-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47133389","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":"Reconstruction of digital composite defects via a free chimeric bone flap based on the superficial palmar branch of the radial artery","authors":"Zhangcan Li, Dawei Zheng, W. Qi, Hui Zhu, R. Shi","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.06.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.06.004","url":null,"abstract":"Objective \u0000To explore the clinical effect of free chimeric bone flap based on the superficial palmar branch of radial artery to repair finger composite tissue defects. \u0000 \u0000 \u0000Methods \u0000From July, 2013 to January, 2016, 9 cases of finger composite tissue defect were repaired by free chimeric bone flap from the wrist crease area. The flap and bone flap were taken with the superficial palmar branch of the radial artery during the operation. The area of the flap was 1.5 cm × 4.0 cm to 3.5 cm× 6.5 cm, and the size of the bone flaps were 0.5 cm × 1.0 cm × 1.5 cm to 1.0 cm × 2.5 cm × 3.5 cm. Regular followed-up was done after the operation. \u0000 \u0000 \u0000Results \u0000Nine cases of chimeric bone flap survived well, and the average healing time of bone flap was 1.6(1.5-3.0) months. The function and appearance of the patients recovered well. The scars on the donor area was slight. The average two-point discrimination of flap was 6.6(5.3 to 8.6) mm at 6 months after operation. According to the Evaluation Criteria of Thumb and Finger Reconstructive Function Assessment of the Upper Limb of the Chinese Medical Association, 7 cases were superior, 1 was good, 1 was medium. \u0000 \u0000 \u0000Conclusion \u0000The free chimeric bone flap pedicled with superficial palmar branch of radial artery can simultaneously repair soft tissue and bone defects. It helps shorten the course of disease and speed up the recovery of finger function. It is a new choice to repair finger tissue defects. \u0000 \u0000 \u0000Key words: \u0000Finger injuries; Chimenic bone flaps; Superficial palmar branch of radial artery; Microsurgical operation","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"534-537"},"PeriodicalIF":0.0,"publicationDate":"2018-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41694964","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 muscular flap and induced membrane technique in the emergency treatment for limb salvage for Gustilo type III B and III C open fracture of lower leg","authors":"Li Yu, Yong Zhao, Zhe Xie, B. Wang, Linglong Deng, Chi Wei, Kai Deng, Guo-rong Yu","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.06.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.06.005","url":null,"abstract":"Objective \u0000To investigate the clinical effectivity of the muscular flap transposition and induced membrane technique in the emergency treatment for the limb salvage of Gustilo type III B/C open fracture of lower leg. \u0000 \u0000 \u0000Methods \u0000From July, 2015 to December, 2017, 10 cases of Gustilo type III B/C fracture of lower leg with bone defects were performed limb salvage surgery. Induced membrane technique was used to fill the bone defects in the emergency room. The gastrocnemius and/or soleus muscular flaps were transposed to cover the bone cement or exposed bone simultaneously in emergence treatment. After the wound healed completely, traditional bone grafting was used to repair the bone defects. There were 4 cases of Gustilo type III B and 6 cases of Gustilo type III C. The average length of bone defect was (5.25±1.70) cm ranging from 3.0 cm to 11.0 cm. The gastrocnemius medial head flaps were performed in 5 cases, the combined application with the gastrocnemius medial head flaps and the medial hemimuscular flaps of soleus were performed in 2 cases, and medial hemimuscular flaps of soleus were transposed in 3 cases. \u0000 \u0000 \u0000Results \u0000The wounds in 6 cases were healed at one stage, but 2 cases healed by dressing because the exudate after skin grafting. In 1 case, the cross-leg flap was used to cover the exposed bone cement due to the necrosis of soleus flap. The other 1 was performed the transposition of the lateral gastrocnemius flaps because the exposure of bone cement after the necrosis of the upper and lateral muscles in lower leg. In the second-stage, the bone defects were reconstructed by traditional bone grafting. The average healed time of bone was 7.2 months ranging from 5 months to 9 months. At the last followed-up time, all patients recovered their function of weight-bearing. The Paley's score of the adjacent joints: excellent in 8 cases and good in 2 cases. \u0000 \u0000 \u0000Conclusion \u0000The combination with induced membrane technique and local muscular flap transposition in emergency surgery is an effective method to limb salvage for the Gustilo type III B/C open fracture of lower leg. \u0000 \u0000 \u0000Key words: \u0000Gustilo type III, Gustilo type; Open fracture of lower leg; Induced membrane technique; Muscular flap; Emergency treatment","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"538-543"},"PeriodicalIF":0.0,"publicationDate":"2018-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48070744","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 the large area soft tissue defect of foot and ankle with free bilateral anterolateral femoral perforator flap in series","authors":"Huanwei Sun, Yiming Zhong, Hongquan Zhang","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.05.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.05.009","url":null,"abstract":"Objective \u0000To investigate the clinical effect of free bilateral anterolateral femoral perforator flap in repairing large area soft tissue defects of foot and ankle. \u0000 \u0000 \u0000Methods \u0000From July, 2013 to December, 2017, 30 patients(19 males and 11 females) with large soft tissue defects of ankle and foot were treated, aged 21-52 years. The defects were located in the middle and distal part of the foot and ankle, the wounds were all exposed with bone, tendon or internal fixator, and the area of skin defect was 15 cm × 22 cm-19 cm× 28 cm. All of them were repaired by free bilateral anterolateral femoral perforator flaps. The perforating branch of bilateral flap was determined by CDU or DSA before operation. According to the area of skin defect and the shape of wound, an appropriate perforating branch flap was designed in the anterolateral thigh region. One perforating branch flap was used as the proximal series flap, the proximal vessel pedicle was anastomosed with the recipient region arteriovenous flap. The other perforating branch flap was used as the distal series flap, the artery and vein were anastomosed between the two flaps. The total area of the two flaps was 17 cm × 25 cm-23 cm × 32 cm. The survival of the flap and the functional recovery of the repair site were observed and the clinical effect was evaluated. \u0000 \u0000 \u0000Results \u0000There was no vascular crisis after operation, and the flaps survived. Followed-up for 5-28(mean, 13.5)months showed that the flap had good blood flow, soft texture and good elasticity, among which 4 cases were slightly bloated and improved after plastic operation. After operation, 26 cases were excellent(90-100 points), 4 cases were good(75-89 points), and the average score of AOFAS was 93.8 points. \u0000 \u0000 \u0000Conclusion \u0000The traffic accident of anterolateral perforating branch and the attention in the process of flap cutting and series were summarized. \u0000 \u0000 \u0000Key words: \u0000Foot; Ankle; Anterolateral femoral perforator flap; Repair; Microsurgical operation","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"450-453"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41529976","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 the soft tissue defects combined dead space in lower extremities with the descending branch of lateral circumflex femoral artery chimeric perforator flap","authors":"Ju-yu Tang, Jiqiang He, Panfeng Wu, Zheng-bing Zhou, Fang Yu, Li-ming Qing, Ding Pan, X. Pang, Lei Zeng, Yongbing Xiao","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.05.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.05.003","url":null,"abstract":"Objective \u0000To investigate the feasibility and clinical effects of chimeric perforator flap based on the descending branch of lateral circumflex femoral artery(d-LCFA) for reconstructing the three-dimensional tissue defect in lower extremities. \u0000 \u0000 \u0000Methods \u0000From May, 2008 to June, 2017, 79 cases of soft tissue defects with dead space were repaired by using a d-LCFA chimeric perforator flap, in which 33 cases of car accident trauma, 12 cases of chronic tibial osteomyelitis, 10 cases of plowing machine injury, 9 cases of chronic calcaneal osteomyelitis, 6 cases of falling injury, 5 cases of crushing injury, 3 cases of spoke injury, and 1 case of suppurative knee arthritis. These patients were accompany with different degrees of infection and dead space after radical debridement. The dead cavity was filled by muscular flap, and perforator flap covered the superficial wound. Recording the flap’s appearance, color, texture, osteomyelitis recurrence and the patient’s knee extension at 1, 3, 6, 9 and 12 months followed-up. \u0000 \u0000 \u0000Results \u0000Seventy-five flaps survived without complications, and the donor sites were closed directly. All patients had no postoperative hematoma or secondary infection. Vascular crisis occurred in 2 days after the operation in 4 flaps, 1 flap had an arterial crisis on the second-postoperative-day, and the flap was necrotic after surgical exploration. The deep circumflex iliac artery chimeric perforator flap was used for repairing. Three flaps with venous crisis during 48 h after operation, in which 2 flaps survived eventually after surgical exploration, and another flap was necrosis and repaired by skin graft. The followed-up periods ranged from 3 months to 30 months(mean, 9.7 months). All flaps had satisfied with appearance and texture. There were no osteomyelitis recurrence and any ranges of motion limitations in the hip and knee joints of the operated leg. \u0000 \u0000 \u0000Conclusion \u0000The chimeric perforator flap with d-LCFA merely anastomosed 1 group vascular pedicle can make the dead space be filled and cover the superficial wound simultaneously. It is an ideal option for reconstructing the skin defect with dead space in lower extremity, which can improve the quality of restoration of recipient site and reduce the damage of donor site. \u0000 \u0000 \u0000Key words: \u0000Lateral circumflex femoral artery, descending branch; Chimeric flap; Perforator flap; Dead space; Lower limb; Microsurgical technique","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"424-427"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41552083","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 chimeric anterolateral thigh cutaneotendinous flap with rectus femoris muscular flap for repairing the complex tissue defect of dorsum wrist","authors":"A. Guo, D. Song, Liang-jun Zheng, Yan-quan Jin, Cai Lingmin, Zan Li","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.05.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.05.010","url":null,"abstract":"Objective \u0000To explore the clinical outcome of free chimeric anterolateral thigh cutaneotendinous flap with rectus femoris muscular flap for repairing the complex tissue defect of dorsum wrist. \u0000 \u0000 \u0000Methods \u0000From June, 2005 to March, 2014, free chimeric anterolateral thigh cutaneotendinous flap with rectus femoris muscular flap was used for repairing the complex tissue defect of dorsum wrist in 15 cases, which were 12 males and 3 females, and aged from 18 to 52 years old. The skin and soft tissue defect ranged from 8.0 cm×5.5 cm to 22.0 cm×12.0 cm. All accompanied with extensor digitorum tendon loss. The tendon defect ranged from 5.0 cm to 12.0 cm (7.6 cm on average). The flap size ranged from 9.0 cm×6.5 cm to 23.0 cm×13.0 cm. The pedicle length ranged from 4.0 cm to 7.0 cm (5.3 cm on average). \u0000 \u0000 \u0000Results \u0000All flaps survived, and no postoperative complications occurred. The followed-up time ranged from 12 months to 36 months, and the texture of flap was flexible. No bulky was noted, and skin color was similar to the hand skin. The flexor and extensor function of wrist recovered satisfying. The 2-point discrimination of flap ranged from 9 mm to 15 mm(12.5 mm on average). \u0000 \u0000 \u0000Conclusion \u0000Free chimeric anterolateral thigh cutaneotendinous flap with rectus femoris muscular flap is a good option for repairing the complex tissue defect of dorsum wrist. \u0000 \u0000 \u0000Key words: \u0000Anterolateral thigh flap; Transplantation; Rectus femoris muscle; Chimeric flap; Tendon defect; Wrist","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"454-458"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46797375","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":"V-Y advancement flap based on the double perforators of the posterior tibial artery for reconstruction of small-area tissue defect in the achilles tendon","authors":"Lei Xu, J. Ju, Qianheng Jin, Heyun Cheng, You Li, Guodong Jiang","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.05.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.05.002","url":null,"abstract":"Objective \u0000To explore the clinical effect of complete transposition of arteriovenous in free flap artery crisis. \u0000 \u0000 \u0000Methods \u0000From October, 2009 to April, 2017, 13 cases of extremities tissue defect were repaired with free flaps. The intractable arterial crisis appeared after transplantation. Repeated anastomosis vessels were adapted but it was not relieved. Then the complete transposition of arteriovenous was adapted in the flaps. Namely the vein of the flap was anastomosed with the arterial in the recipient site to reconstruct the blood supply, and the arterial of the flap was anastomosed with the vein in the recipient site to reconstruct recirculation. Ten cases of hand defect and 3 cases of crus defect were repaired by 5 low abdominal flaps and 8 anterolateral thigh flaps. The tissue defect area was 16 cm×7 cm-6 cm×4 cm and the flap area was 18 cm×8 cm-7 cm×4 cm. \u0000 \u0000 \u0000Results \u0000Ten flaps survived completely, the other 3 flaps almost survived that scab healed in 1 case and skin grafted in 2 cases. The flap for skin color was from purple red to dark red, and finally close to normal, and skin flap edge would have different degrees of ecchymosis; the bleeding from the incision of the skin flap was from dark red to bright red; the swelling of the flap was obvious in the early stage and the later swelling subsided. All cases were followed-up from 6 months to 32 months with an average of 16 months. The wounds healed well. The flaps had a clear boundary and soft texture. \u0000 \u0000 \u0000Conclusion \u0000Complete transposition of the arteriovenous system can be used as an alternative in the presence of intractable arterial crisis after free flap transplantation, to save the flap and to reduce the trauma to the patient. \u0000 \u0000 \u0000Key words: \u0000Free flaps; Arterial crisis; Transposition of the arteriovenous; Repair","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"421-423"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43600022","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":"Modified thin anterolateral thigh flaps for reconstruction of hand and foot defects","authors":"L. Yin, K. Gong, Jianhua Xu","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.05.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.05.001","url":null,"abstract":"Objective \u0000To evaluate the clinical efficacy of modified thin anterolateral thigh flaps for reconstruction of hand and foot defects. \u0000 \u0000 \u0000Methods \u0000Between March, 2016 and September, 2017, 17 patients were reconstructed with modified thin anterolateral thigh flap. There were 6 cases for reconstruction of hand, and 3 of them were located in the back dorsal of hand defects. There were 11 cases for reconstruction of ankle and foot, and 5 of them were located in the dorsal of foot. The size of the flap was 5 cm×3 cm-33 cm×10 cm. The traditional perforator flap was elevated just above the deep fascial plane. The debulking procedures could follow before the pedicle was cut off. The modified method was that the flap was elevated from the superficial fascia and the plane between deep and superficial fat without intraoperative debulking procedures. \u0000 \u0000 \u0000Results \u0000Three flaps were eventually survived after secondary exploratory operation caused by the hematoma. Two flaps had partial loss, 1 of which needed secondary skin grafting, and the other flap healed with additional intention. Followed-up period was 3-18(average, 7) months . All flaps showed relatively good contour and the patients were satisfied with clinical outcomes. \u0000 \u0000 \u0000Conclusion \u0000It is a safe and reliable way that perforator flap can be elevated from the superficial fascia and the plane between deep and superficial fat. It can obtain a thin flap immediately and reduce donor-site morbidity without additional defatting and time-consuming. The flap is soft with good contour. This technique is an ideal option for covering defects composed of dorsal of the hand or foot and the head and neck regions. \u0000 \u0000 \u0000Key words: \u0000Anterolateral thigh flap; Perforator flap; Modified method of thin type flap; Microsurgical operation","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"417-420"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41909525","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":"Analysis of the causes and the countermeasures for the serious complications after perforating pedicle flap of lower leg","authors":"Yiyang Liu, Li-feng Shen, B. Lin, Kai Huang, Zhan Zhang, Q. Guo","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.05.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.05.007","url":null,"abstract":"Objective \u0000To analysis causes of the serious complications after the operation of the lower leg perforator pedicle screw flap, and to explore the corresponding countermeasures. \u0000 \u0000 \u0000Methods \u0000From June, 2012 to August, 2016, 60 cases of soft tissue defect of ankle and foot were repaired with propeller flaps pedicled with perforator of lower legs. with the area were soft tissue defect ranged from 3.0 cm×2.0 cm to 19.0 cm×9.0 cm, and all with bone exposure. Two cases of traumatic tissue defect, 7 cases were chronic osteomyelitis of the distal tibia, 13 cases were incision infection and necrosis after the operation of ankle joint fracture and Pilon fracture, 10 cases were simple incision necrosis after calcaneal fracture, 18 cases were calcaneal osteomyelitis, 1 case were soft tissue defect after the ankle tumor operation, 6 cases were soft tissue necrosis after the Achilles tendon rupture, and 3 cases were soft tissue defect of the dorsum with infection. The posterior tibial artery perforator pedicled propeller flap was used in 18 cases. The pedicle of the vascular pedicle was 6.0-18.0 cm from the medial malleolus, the flap rotation was 135°-180°. There were 42 cases of the perforator pedicle propeller flap of the peroneal artery, 5.0-18.0 cm from the pedicle of the vascular pedicle and 120°-180° rotation in the flap. The area of the flap was 9.0 cm×3.0 cm-34.0 cm×18.0 cm. There were 32 cases of direct suture in the donor site and 28 cases of free skin grafting. \u0000 \u0000 \u0000Results \u0000The color, swelling, elasticity, capillary reaction and healing of donor site were observed after operation. There was no flap ischemia occurred in 60 patients. Fourteen cases had venous reflux obstruction, all of which had swelling above II degree, 8 cases had swelling above III degree with obvious purple blood stasis, resulting in partial flap necrosis in 4 cases, all necrosis in 1 case, including 4 cases of free skin grafting, 1 case of flap transplantation and repair. There were 3 cases of necrosis after skin grafting in the flap area, all of which were partial necrosis. There was case of necrosis of the wound surface after direct suture of the donor site and 1 case of skin disintegration after disassembly, and all wounds healed after the replacement of the wound and the external use of the dried blood powder. All the 60 patients were followed-up for 12 to 30 (mean, 24.5)months. The flaps survived and the donor site scars healed well. The range of motion of the ankle was from -10°to 10°(mean, 5.6 °) and the flexion of the plantar was from 20 °to 50 °(mean, 37.8 °). Fourteen patients with venous reflux disorder were followed up for 15 to 28(mean, 22.3)months. The flap and skin graft survived well. Ankle dorsiflexion ranged from -10° to 10 °(mean, 2.4 °) and plantar flexion from 20° to 45 °(mean, 35.6 °). There was no obvious limp in walking. \u0000 \u0000 \u0000Conclusion \u0000Although the overall effect of the lower leg perforator pedicle propeller flap to repair the soft tissue defect of the","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"441-445"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44215742","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":"Comparative study of two different surgical methods for the treatment of Garden III and IV femoral neck fractures in young adults","authors":"Dong Zhang, Aixi Yu, Guo-rong Yu, S. Tao, Zheng-yu Pan, Baiwen Qi, Weidong Xiao, Kai Deng","doi":"10.3760/CMA.J.ISSN.1001-2036.2018.05.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2036.2018.05.004","url":null,"abstract":"Objective \u0000To compare internal fixation with hallow compression screws combined vascularized bone graft (observation group) with only three hallow compression screws (control group) in young patients’ Garden III and IV femoral neck fractures. \u0000 \u0000 \u0000Methods \u0000The patients with femoral neck fracture were treated from January, 2004 to December, 2013 were retrospectively reviewed. A total of 417 displaced femoral neck fractures in young and middleaged patients were long term followed-up. One hundred and thirty-seven patients were underwent open reduction and internal fixation with 3 hallow compression screws combined with a greater trochanter bone graft supported by the profound branch of medial circumflex femoral artery; 280 patients were treated by closed reduction with 3 hallow compression screws. \u0000 \u0000 \u0000Results \u0000Patients had been followed-up for 5-12 years. At the last follow-up point, the Harris score of flap in observation group(93.68±5.12) were higher than that in control group(92.53±6.12), while it was no statistical difference(P>0.05). It was 0.7% of nonunion incidence rate in the observation group, and incidence of avascular necrosis of femoral head was 6.6%, and incidence of femoral neck shortening was 8.8%. In the control group, incidence of avascular necrosis of femoral head was 14.6%, nonunion incidence rate was 4.6%, and incidence of femoral neck shortening was 22.5%. The differences between two groups was statistically significance(P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The open reduction and internal fixation which is hallow compression screws in combination with a greater trochanter bone graft supported by the profound branch of medial circumflex femoral artery is an optimal treatment for young adults with Garden III and IV femoral neck fractures. \u0000 \u0000 \u0000Key words: \u0000Femoral neck fracture; Garden type; Internal fixation; Bone graft; Transposition","PeriodicalId":60782,"journal":{"name":"中华显微外科杂志","volume":"41 1","pages":"428-432"},"PeriodicalIF":0.0,"publicationDate":"2018-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46059776","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}