ABSTRACT
Transposition of simple or composite forearm island flaps with a radial vascular pedicle was performed in repairing tissue defects of the hand and reconstruction of the thumb in 16 patients. It was found to be easy to operate and no suturing of blood vessels was necessary. The postoperative swelling was less marked. The flap was good in texture and sensation after the operation. The overall result wassatisfactory. Anatomic-physiological situdy was also carried out. 16 patients have been operated on, including 2 thumb reconstructions, with satisfactoryresults.
ABSTRACT
For the need of lymphovenous anastomosis in microsurgery, the following investigations were carried out: the anatomy of the superficial lymphatic system of the limbs (by direct injection method on 40 cadaverous specimens); mimic surgical incisions (on 2 specimens) and the criteria of searching and differentiating the small lymph channels from the small blood vessels and nerves (on 29 cases of limb operations).1. The limb superficial lymph vessels are arranged in two layers, those in the superficial layer are smaller in size but large in number than that in the deeper layer. The large collecting lymph vessels run alongside the chief superficial vein.2. The location, course, number and diameter of the superficial lymph vessels were studied.3. The morphological criteria of differentiating the small lymph vessels from the minute blood vessels and nerves under surgical microscope were suggested.4. The relationships between the distribution of the lymphatic valves and the site of surgical approach were discussed. The valves were found onlyat the distal portion of the "lymph-pearl" and the proximal part of the "pearl" will be the suitable site for surgical incision.
ABSTRACT
The upper limbs of 23 adult cadavers were dissected and the internal structures of the median nerve were studied for microsurgery of the nerve.Under operative micros- cope(24X),the median nerves of 20 cadavers treated with 10% acetic acid were dissec- ted.The median nerves of the remaining three were cross-sectioned,inch by inch,and stained with Sudan Ⅲ for microscopic observation.Microscopic ptotographs were taken to visualize the intra-neural topography of motor bundles or bundle groups. 1.The morphology,topographic relationships,size and number of bundles of the median nerves were observed under microscope and were recorded. 2.At the level of the arm and forearm,the nerve trunk and its internal bundles appear to twist to a certain degree in the way of external rotation from the distal to proximal. 3.The motor bundles of the thenar muscles emerge at the level about 40.1mm below the styloid process of radius.They enter the nerve trunk anteriorly on the radial side,and run upward at the Rower part of the forearm,and continue postero-laterally and appear as a admixture of sensory and motor nerves.At the mid-portion of the fore- arm,they are situated posteriorly,while at the level of antecubital fossa and above, they occupy the central position and finally most of the bundles join the medial head of the median nerve. 4.The motor bundles that supply the flexor muscles of the forearm are located anteriorly and posteriorly in separate portions after entering the nerve trunk.At the level of the arm,these two portions of median nerve are mixed bundles but motor nerve fibers predominate. 5.The fundamental method of funicular suture were discussed in relation to the intra-neural topography of the median nerve.
ABSTRACT
In addition to the three existing types of skin flaps, supplied by the cutaneous, the myocutaneous and the arterio-reticular vessels, a new type of free skin flap pedicled by the vessels of intermuscular septum was designed. The intermuscular septal arteries are easy to dissect and have relatively longer pedicles. The skin flaps taken from the limbs supplied by these arteries are suitable for grafting in their natural location.The intermuscular septal arteries of the arms and the thighs were studied and measured on 70 adult cadavers and 9 corrosion preparations. The arteries studied were: the superior ulnar collateral arteries, the intermuscular branches of the perforating arteries and the saphenous branches of the highest genicular arteries. The skin flaps supplied by these arteries were studied with regard to their application in surgery and these vessels were believed to be convenient for the microvascular anastomosis during grafting.The practical value of the skin flaps taken from the medial and lateral sides of the arm, the lateral side of the thigh and the medial side of the leg were discussed.