Choke vessel growth in perforator flaps and the conception of angiosome / 中国组织工程研究

BACKGROUND: Perforator flaps are used to repair skin and soft tissue defects. As a bridge between adjacent perforator vessels, choke vessels play an important role in the survival of extended perforator flap. OBJECTIVE: To review the research status and progress of the growth of choke vessels in perforator flaps. METHODS: A computer-based search of PubMed, CNKI and SinoMed databases was performed for the relevant literature concerning the research status and progress of the growth of choke vessels in perforator flaps published from 1984 to 2017. The keywords were "perforator flap, perforator vessels, choke vessels, choke zone" in English and Chinese, respectively.RESULTS AND CONCLUSION: Totally 51 articles were included for summary. Perforator flaps are extensively used to repair skin and soft tissue defects caused by various factors. Adjacent perforter vessels are connected by choke vessels, and the extended perforter flap survival is closely related to the dilatation and growth of choke vessels. Similarity may exist between the growth of choke vessel and angiogenesis. Hypoxia and ischemic preconditioning and inflammatory environment may promote the growth of choke vessels.

Surgical treatment strategy for flatfoot related with accessory navicular / 中国骨伤

Accessory navicular source flatfoot is one of the foot deformity of clinical common disease,its treatment method is more controversial, differences in clinical efficacy of different surgical methods, according to accessory navicular source flatfoot symptoms of surgical treatment,there is no uniform standard, around a pair of accessory navicular excision how to reconstruct the arch produced a series of operation methods, the clinical curative effect of different operative methods produce also different, how to develop the operation strategy, choose operation method, and after acessory navicular excision whether to rebuild posterior tibial tendon, how to rebuild, the problems such as how to rebuild is the research hotspot and difficulty, looking forward to further research.

Application of the tension skin flap with different shapes in the pedicle of the reverse neurocutaneous island flap / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effects of the tension skin flap with different shapes on the transplantation of the reverse neurocutaneous island flap.</p><p><b>METHODS</b>From January 2006 to January 2012,there were 21 patients in the study (including 15 males and 6 females), and aged from 14 to 58 years old (35 years old on average). Tension skin flaps with different shapes (triangle ,round and ellipse) were used to improve the blood supply of the reverse neurocutaneous island flap. The tension skin flaps in the pedicle were designed triangularly (10 patients), spherically (8 patients) or elliptically (3 patients). There were 5 patients with defects in the hand (the size from 5.0 cm x 2.0 cm to 8.0 cm x 5.0 cm), and 16 patients with defects in the foot and inferior segment of leg, or around the ankle (the size from 6.0 cm x 4.0 cm to 13.0 cm x 7.0 cm). And all the patients were with the tendon and bone exposed. All the flaps were reversal transplanted, including 5 dorsal neurocutaneous flaps of foot, 4 superficial peroneal neurocutaneous flaps, 4 saphenous neurocutaneous flaps, 3 sural neurocutaneous flaps, 2 superficial radial neurocutaneous flaps, 3 lateral neurocutaneous flaps of forearm. And the survival rate, appearance and sensory recovery of the flaps were analyzed.</p><p><b>RESULTS</b>The distant part of the reversed sural neurocutaneous island flap in 1 case necrosized and healed after dressing change. The other flaps survived entirely, and the donor site all healed primarily. The follow-up time was from 3 months to 2 years (averaged 7 months), and all the flaps had recovered pain and warm sensation with perfect appearance.</p><p><b>CONCLUSION</b>The tension skin flap in the pedicle can enhance the blood supply and promote survival rate of the reverse neurocutaneous island flap, and can also improve its appearance.</p>

Clinical effect analysis of total knee replacement for treating gonarthrosis with severe deformities / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the prosthesis selection, precaution and curative effect of total knee replacement in severe gonarthrosis.</p><p><b>METHODS</b>From January 1996 to July 2009, 50 patients (58 knees) with severe gonarthrosis underwent total knee replacement, included 12 males and 38 females, aged from 46 to 80 years with an average age of 66.5 years old. Six artificial hinged knee joints, 37 general knee joints and 15 ScorpioNRG knee joints were used according to the deformity of the knees. Fifty patients (58 knees) were followed up and evaluated with the HSS (the Hospital for Special Surgery Knee Score) scoring system.</p><p><b>RESULTS</b>The duration of follow-up ranged from 6 months to 8 years (means 62 months). According to the HSS scoring system, the mean preoperative score was (38.6 +/- 8.76) points, and the postoperative score was (86.50 +/- 9.45) points. The clinical effect was excellent in 20 cases (23 knees), good in 28 cases (32 knees),and acceptable in 2 cases (3 knees).</p><p><b>CONCLUSION</b>Stable and functional recovery knee joint without deformities and pains could be obtained after total knee replacement by carefully chosing of prosthetic replacements according to the different degrees of joint deformity of severe gonarthrosis.</p>