The clinic application of thoracodorsal artery perforator flap: a report of 16 cases / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of free and pedicled thoracodorsal artery perforator (TDAP) flaps for repairing skin and soft tissue defects in limbs, neck, axillary and shoulder.</p><p><b>METHODS</b>From October 2009 to Auguest 2011, 16 TDAP flaps were used to repair skin and tissue defects. Among them, five ipsilateral pedicled flaps were used to repair wounds in neck, axillary and shoulder. 11 free TDAP flaps were used to repair the wounds with bone or tendon exposure. In 12 cases, the flaps were pedicled with thoracodorsal artery and vein-lateral branches-perforators, in 4 cases, pedicled with thoracodorsal artery and vein-serratus anterior muscular branches-perforators. The deep fascia, the latissimus dorsi and thoracodorsal nerve were not included in all flaps. The flaps size ranged from 10 cm x 5 cm to 26 cm x 10 cm.</p><p><b>RESULTS</b>All 16 flaps survived completely with primary healing both at donor site and recipent area. After a follow-up of 3 to 24 months, all flaps gained good texture and appearance. Only linear scar was left at donor area. The shoulder could move freely.</p><p><b>CONCLUSIONS</b>TDAP flap has good texture, long vascular pedicle,and reliable blood supply, leaving less morbidity at donor site. The latissimus dorsi and thoracodorsal nerve are also preserved. The pedicled TDAP flap is an ideal flap for repairing the ipsilateral skin and soft tissue defects of the neck, shoulder, axillary. The free TDAP flap is suited for repairing skin and soft tissue defects of the extremities.</p>

Design and manufacture of the static 3 dimensional screw-plate system and its matching tools / 中南大学学报(医学版)

OBJECTIVE@#To design and manufacture a new type instrument and its matching tools for the proximal femur.@*METHODS@#A new type instrument of subtrochanterical fracture-static 3-dimensional screw-plate system(STDSP)was designed and manufactured. The different types of accessory instruments which adapted to STDSP,the aiming guide, and the accessory tools were also designed and manufactured, and they were tested on bones.@*RESULTS@#STDSP included 3 special lag screws and 1 anatomic plate. The lag screws distributed in femoral neck like "or"shape. There was 135 degree between the lag screws and femoral shaft. The shape of the plate was similar to the anatomic structure of the proximal thighbone. The posterior screw was stably connected to the plate. The plate was affixed crosswise to the lateral and anterior side by bicortical screws. The aiming guides and all kinds of accessory tools could help to install STDSP exactly and conveniently,which was verified on cadavers and X-ray photographs.@*CONCLUSION@#STDSP has the function of dynamic compressing in 3-dimensional space, and can match with the structure of the proximal femur preferably. STDSP may be a suitable instrument to the subtrochanteric fractures. The accessory apparatus of STDSP has simple configuration,and can let the STDSP be installed accurately, conveniently and rapidly.

Different operation methods for thoracolumbar spinal tuberculosis / 中南大学学报(医学版)

OBJECTIVE@#To compare the advantages and disadvantages among the conventional operative methods with the primary anterior debridement, intercentrum auto grafting, and anterior internal fixation method for the thoracolumbar spinal tuberculosis, and to discuss the applying principle.@*METHODS@#Twenty-seven patients with thoracolumbar spinal tuberculosis were treated by the primary anterior debridement, intercentrum auto grafting, and anterior internal fixation, 8 patients were treated by focus debridement and intercentrum auto grafting operations, and the other 22 patients were treated by focus debridement from Feburary 1998 to July 2003, and we analysed the status of the grafting bone fused, the neural function resumed, the malformation rectified and the whole cure ratio.@*RESULTS@#All patients were cured after the follow-up of 15.2 months averagely. Three thoracic spinal and 1 lumbar spinal tuberculosis patients who suffered local infection were cured by debridement and other managements. The time of beginning active movement postoperatively was shortened, and the degrees of kyphosis correction had increased in the anterior internal fixation group compared with the other two groups (P <0.05). But the cost and the bleeding resulted from operation had increased in the anterior internal fixation group compared with the other two groups (P <0.05).@*CONCLUSION@#The conventional and the modern operation methods of thoracolumbar spinal tuberculosis have respective advantages and disadvantages, so that they can complement rather than replace each other.