Hand reconstruction by transplanting the fostered residual finger and second toe which share the same blood supply system / 中华显微外科杂志

Objective To investigate the methods and results of hand reconstruction by transplanting the fostered residual finger and the second toe,which share the same blood supply system.Methods From January,2014 to January,2016,3 cases with destructive hand injuries in our hospital;and debridement was performed in one session during the early stage of trauma,with skin grafting to cover the wrist stump and foster the residual finger to a branch of the dorsalis pedis artery.The first dorsal metatarsal artery around the toe web was identified and then gradually isolated proximally with dissection of the branches of the dorsalis pedis artery supplying the fostered finger until the convergence of the two blood vessels.Then,reconstructed hand by residual finger and combined second toe transplantation.Results After a follow-up period of 3 months to 2 years,the reconstructed hand had a good appearance and was able to complete basic mundane actions.The function of the limb was restored to a large extent andthe patient was satisfied with the reconstructed hand.Conclusion Transfer of a fostered residual finger and combined second toe which have the same blood supply system for hand reconstruction as a new method need to anastomose only one set of arteries,and it is feasible with the good appearance and function of the reconstructed hand.

Repair the lateral skin and soft tissue defect of the middle and rear foot wih the plantar medial flap transferred before the achilles tendon / 中华显微外科杂志

Objective To investigate the methods of repair the lateral skin and soft tissue defect of the middle and rear foot with the plantar medial flap transferred before the achilles tendon.Methods Fifteen cases with the lateral skin and soft tissue defect of the middle and rear foot were repaired with the plantar medial flap pedicled with posterior tibia artery transferred before the achilles tendon from January,2012 to October,2015.All the 15 patients were followed up in the way by telephone or back to hospital postoperatively 3 months to 3 years,including 6 cases by telephone follow-up and 9 cases of back-to-hospital follow-up,to observe the appearance,functions of the skin flap and whether the skin flap survived well.Results The flaps of 15 cases survived well.Postoperative followup of 3 months to 3 years,the sensation of the flap was good,without any ulcer or necrosis.The patients walked well and were satisfied with the flap.Conclusion To repair the lateral skin and soft tissue defect with the plantar medial flap transferred before the achilles tendon as a new method is feasible with the good ability of faster sensory recovery,the good appearance and function.

Discussion on Diagnosis,Treatment and Prognosis of Pilocyticastrocytoma / 医学研究杂志

Objective To discus the diagnosis,favorabl management and diagnosis of pilocytastrocytoma.Methods Provided by the information from CT,MRI and operation,we try to discus and confirm the characteristics of this tumor.Results Pilocytastrocytoma commonly occurs in 20 years old or younger.The most frequent location involve by tumor were cerebellum.The most common presenting sympton was increased intracranial pressure,and then cerebellum symptoms such as incoordination.Final diagnosis made depending on mainly pathology.We found the relationship between prognosis and the extent of surgical removal.Conclusions Pilocytastrocytoma usually occur in children and adolescent.The most common site of these tumors are the cerebellum.And the more complete extent of surgical removal,the better prognosis.So it was called as "benign" tumors.If pilocyticastrocytoma were subtotally excised,the addition of postoperative irradiati could significantly prolong survival.