A V-Y shaped flap with digital artery nerve at metacarpophalangeal joint was used to repair the defect of middle and distal phalanx / 中国骨伤

OBJECTIVE@#To explore a surgical method for the reconstruction of volar soft tissue defect and sensory and vascular repair in middle and far phalangeal digits.@*METHODS@#From January 2016 to January 2020, a total of 14 patients , 9 males and 5 females, ages ranging from 22 to 69 years old, and with volar soft tissue defects in the middle and distal digits 2 to 4, underwent surgical reconstruction using the V-Y shaped flap with digital artery and nerve at the metacarpophalangeal joint. The defect area was (2.0~2.5) cm×(1.5 ~2.0) cm. The procedure involved the harvest of a V-Y shaped flap with the digital artery and nerve from the metacarpophalangeal joint. Flap design, dissection of blood vessels and nerves, and anastomosis with the digital artery and nerve were performed according to a standardized protocol., Functional exercise of affected finger was initiated 3 weeks postoperatively. Subsequent assessments were conducted to evaluate finger pulp sensation, shape and other relevant parameters. According to the upper extremity functional evaluation standard set up by Hand Surgery Branch of Chinese Medical Association, the surgical outcomes were evaluated.@*RESULTS@#All 14 cases demonstrated successful tissue transplantation, , with immediate recovery of sensation observed in 10 cases with distal finger pulp defects. Four patients with middle phalangeal defects experienced gradual sensory recovery within 2 to 3 months postoperatively. Thirteen patients were followed up for a mean duration of (8.8 ± 4.49) months, during which satisfactory outcomes were observed. The average two-point resolution of the finger pulp was 4-6mm, and sensory function evaluation yielded a score of S3 or above. Patients exhibited realistic finger shape, normal skin color and temperature, good wear resistance, and cold resistance. Furthermore, finger joint function was essentially normal.@*CONCLUSION@#The V-Y shaped flap with digital artery and nerve at the metacarpophalangeal joint offers a suitable solution for repairing the defect of the middle or distal phalangeal finger. This technique is characterized by its simplicity, low risk, and favorable outcomes, including restored finger shape, blood supply and sensation. Moreover, high patient satisfaction was achieved.

Analysis of Traditional Chinese Medicine Constitution of Patients with Metabolic Syndrome / 广州中医药大学学报

Objective To investigate the characteristics of traditional Chinese medicine(TCM) constitution of patients with metabolic syndrome(MS), so as to provide individualized therapy for the treatment and rehabilitation of MS. Methods The data of a total of 328 MS patients were collected, covering body height, body mass,body mass index(BMI),waist circumference,blood pressure,blood glucose,blood lipids such as triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C), etc.. TCM constitution types of the MS patients were classified according to Self-rating Scale for Traditional Chinese Medicine Constitution Classification and Discrimination. Results (1)In the 328 cases,the patients with increased TG or having treated with lipid-lowering therapy,the patients complicated with increased blood pressure or having treated with antihypertensive therapy,and the patients with the previous diagnosis of hypertension were dominant,accounted for 41 cases(12.50%).(2)Bias constitution was predominant, showing in 308 cases and accounting for 93.90%. Phlegm-damp constitution was mostly commonly seen in the bias constitution, accounted for 78 cases(23.78%). And then the damp-heat constitution, Qi stagnation constitution, complicated constitution, Qi deficiency constitution, yang deficiency constitution, blood-stasis constitution, yin deficiency constitution and specific constitution came next orderly. Twenty patients had the harmony constitution, accounting for 6.10%. (3)MS patients with phlegm-damp constitution had higher body mass and BMI than the patients with harmony constitution, the difference being significant (P < 0.05). The differences of TG were significant between the phlegm-damp constitution and the specific constitution(P <0.05). Conclusion The included MS patients have typical clinical manifestations, and their TCM constitution types are commonly seen as phlegm-damp constitution,damp-heat constitution,and Qi stagnation constitution. The results of constitution discrimination will supply evidence for the individualized therapy for the treatment and rehabilitation of MS patients.