Clinical application of lateral superior genicular composite tissue flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical effect of lateral superior genicular composite tissue flap for tissue defect.</p><p><b>METHODS</b>The axis line of flap is the lateral thigh vertical midline. The cutaneous branch is inserted 4 cm near the femoral lateral epicondylus. The anterior border is the elongation line along patellar lateral border. The posterior margin is the hinder margin of femoral biceps. The lower border is the horizontal line along the upper line of patella. The composite flaps were used in 18 cases with soft tissue defects in extremities, 11 cases with clacaneus tenden defects and 16 cases with bony nonunion. Results From Mar. 2002 to Sept. 2013, 45 cases were treated with the composite tissue flaps. The flaps size ranged from 6 cm x 3 cm to 17cm x 9 cm. All the flaps survived completely. Blood supply crisis happened in 2 cases, which was released by reanastomosis. The patients were followed up for 1 - 2. 5 years with satisfactory aesthetic and functional results. All the bone defect and nonunion were healed. Good healing was also achieved in donor sites. 8 months after operation, knee joint function is evaluated as good by hospital special surgery knee score (HSS).</p><p><b>CONCLUSION</b>Lateral superior genicular compostie tissue flap can be used to reconstruct soft tissue defect, bone defect and tenden calcaneus defect in one stage.</p>

Primary reconstruction of skin avulsion injury on both feet / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of primary reconstruction of skin avulsion injury with bilateral anterolateral thigh flaps combined with thorax umbilicus flap or latissimus dorsi flap.</p><p><b>METHODS</b>From June 2005 to Aug. 2011, 4 cases with skin avulsion injury on both feet were treated. The bilateral anterolateral thigh flaps, including with anterolateral thigh cutaneous nerves, were transferred to cover the feet plantar. The thorax umbilicus flap or latissimus dorsi flap were used to cover the feet dorsum.</p><p><b>RESULTS</b>All the skin avulsion injury were reconstructed primarily. All the flaps survived completely with good cosmetic and functional results. The patients were followed up for 6 months to 2 years with good sensory recovery (two point discrimination: 14-18 mm).</p><p><b>CONCLUSION</b>The skin avulsion injury on both feet can be primarily reconstructed by bilateral anterolateral thigh flaps combined with thorax umbilicus flap or latissimus dorsi flap.</p>

Applied anatomical and clinical application of reconstruction of the medial malleolus with bone-severed vascularized fibular head epiphysis / 中华显微外科杂志

Objective To provide an anatomical basis for repairing the medial malleolus with bone-severed vascularized fibular head epiphysis, and to explore the effect of clinical application with this method. Methods Figures of fibular head and medial malleolus were measured on 20 fresh lower limbs specimens of child age from 2 to 12 years old, then bone-severed formula was deduced. The bone-severed composite fibular head epiphysis to repair the defect of medial malleolus were carried for 6 child patients of emergency or post-poned cases on one stage. Obersved the clinical effect by following-up. Results The angle between fibular head and stem (M) was(170±8)°, angle of fibular head sadacc(N) was (145 ±6)°, length(1.5±0.2)cm and width (1.4±0.2)cm; angle between medial malleolus and stem(1) was(152±8)°, length of the articular surface of medial malholus was(1.25 ± 0.2)cm and width (1.25 ± 0.2)cm. Angle between defect surface and tibia was(Q). Formula: angle of bone-severing X = L-N-Q, and apex at the upper 1/6 of the reversed articular surface of fibular. 6 cases with this method was completed, all healed at stage one, following-up 1 to 3 years, medial malleolos developed well and no epiphysis ossification anticipation, and the ankle joint has no inversion with its loadind and walking function good. Conclusion The fibular head epiphysis and the medial malleolus differ in shape to some extent, but good donor can be got by bone-severing, can repair the epiphysis and soft tissue defect of the medial malleolus at one stage with additional flap, developing with the child at the same time, it is a perfect method to reconstruct the traumatic defect of child medial malleohs.

The reparation of flyback avulsion injury of skin in foot by anterolateral thigh flap and sural neurovascular flap with their neural anastomosis / 中华骨科杂志

Objective To discuss the clinical effect about flyback avulsion injury of skin in foot that repaired by anterolateral thigh flap and sural neurovascular flap with their neural anastomosis.Methods 14 patients including 10 males and 4 females,from 16 to 58 years old,with an average of 31 years.The anterolateral thigh flap taking along anterolateral thigh cutaneous nerve was cut to repair wall and sole of foot,at the same time,the anterolateral thigh cutaneous nerve and the medial plantar nerve was anastomosis;the lateral plantar nerve was embedded in the anterolateral thigh flap that was used to repair sole of foot.The sural neurovascular flap was reversed to repair lateral part of foot,and the superficial peroneal nerve was sutured with sural exterior and interior cutaneous nerve.According to Swanson evaluation of clinical effect of peripheral nervous impairment,the sensation of flap was classed as S1,S2,S3,S4,S5;the area of sensory recovery was classed as R1(