ABSTRACT
Objective To investigate the effect of iliac flap pedicled with superficial circumflex iliac artery and sartorius in the treatment of femoral neck fracture of the young adults.Methods From April,2012 to March,2017,50 cadaveric lower limbs were injected with red latex,and the origin,diameter,course and distribution of the superficial circumflex iliac artery and arteries of the sartorius were observed.The iliac flap pedicled with superficial circumflex iliac artery and sartorius was used to treat the femoral neck fracture in young adults in 11 cases.There were 9 males and 2 females with an average age of 34.5(ranged from 16 to 54) years.The fractures were classified ac cording to Garden:4 cases of type Ⅲ and 7 cases of type Ⅳ.Regular outpatient follow-up was made.Results The superficial circumflex iliac artery originated from the femoral artery and the initial diameter was (1.2±0.3) mm.The length of the superficial circumflex iliac artery to the anterior superior iliac spine was (8.8±1.3) cm.The superficial circumflex iliac artery run to the anterior superior iliac spine and sent 1-3 periosteal branches into the iliac crest.The sartorius originates from the anterior superior iliac spine,and its proximal artery arises from the superficial circumflex iliac artery and the femoral artery.Link-pattern arterial anastomosises were formed in sartorius by branches of adja cent vascular pedicles,which nourished the ilium flap.All incisions healed by first intention.All cases were followedup from 16 to 42 months,with an average of 32.3 months.All fractures healed for 3-7 months,with an average of 4.6 months.No fracture nonunion,femoral head necrosis and other complications occurred.Harris hip scores was 93.02± 5.33.Seven cases were excellent and 4 cases were good.Conclusion The iliac flap pedicled with superficial cir cumflex iliac artery and sartorius has rich blood supply,easily performed conducive to promoting fracture healing,and reducing the occurrence of femoral head necrosis.It is an effective method for the treatment of femoral neck fracture in young adults.
ABSTRACT
Objective To investigate the effect of retrograde sartorius myocutaneous flap for reparing skin defects of leg.Methods In the anatomic study,50 cadaveric lower limb were injected with red latex and the origin,diameter,course,distribution and anastomosis of sartorius's arteries were observed.Arteriographies were made in 4 sides of fresh specimens to study the arterial anastomosis in sartorius.Based on anatomic research results,we designed the retrograde sartorius myocutaneous flap for reparing skin defects of leg.Results Nutrient arteries of sartorius represented segnental distribution,Link-pattern arterial anastomosises were formed in sartorius by branches of adjacent vascular pedicles.Cutaneous arteries and musculocutaneous arteries above deep fascia formed interlocking arterial anastomosises net which provided blood supply for the skin on sartorius.The arterial branches in the distal 2/5 of sartorius came from saphenous artery,composed an arterial network around knee joint,which consist of anatomic basis for the blood supply of retrograde sartorius myocutaneous flap.Form February,2010 to April,2014,the retrograde sartorius myocutaneous flap were used to repair skin defects of leg in 2 cases.The flap size ranged from 7 cn×18 cm to 12 cm×25 cm.All flaps survived successfully with no ulcer.2 cases were followed up for 7 to 16 months.The skin color and texture were satisfactory.Conclusion the retrograde sartorius myocutaneous flap has constantly,reliable blood supply,and easily performed.It is an effective method for the reconstruction skin defects of leg.
ABSTRACT
Objective:To explore the correlation among serum levels of brain natriuretic peptide (BNP) ,testosterone (T) , free three triiodothyronine (FT3) and heart function ,prognosis in male patients with chronic heart failure (CHF) .Meth‐ods:A total of 116 male CHF patients (CHF group) and 40 male patients with cardiovascular diseases and normal cardiac function (normal cardiac function group ) were enrolled .According to NYHA cardiac function class ,CHF group was divid‐ed into classⅡ group (n=41) ,class Ⅲ group (n=37) and class Ⅳ group (n=38);according to presence of cardiovascular events or not ,CHF group was divided into cardiovascular event group (n=36 ,event group) and non- cardiovascular event group (n=80 ,non- event group) .Serum levels of BNP ,T and FT3 were compared among above groups ,and the correla‐tions among those indexes and cardiac function were analyzed .Results:Compared with normal cardiac function group ,ser‐um BNP level significantly rose ,serum levels of T and FT significantly reduced in CHF group ( P<0.01 all) .Compared with classⅡ group ,serum BNP level significantly rose [(262.13 ± 125.08) ng/L vs .(674.65 ± 189.29) ng/L vs .(1072.91 ± 362.74) ng/L] in class Ⅲ group and class Ⅳ group ,and that of class Ⅳ group was significantly higher than that of classⅢ group;there were significant reductions in serum levels of T [(5.87 ± 1.12)μg/L vs .(4.56 ± 0.98)μg/L vs .(3.52 ± 0.74)μg/L] and FT3 [(4.70 ± 0.64) pmol/L vs .(3.68 ± 0.59) pmol/L vs .(2.18 ± 0.61) pmol/L] in class Ⅲ group and class Ⅳ group ,and those of class Ⅳ group were significantly lower than those of class Ⅲ group , P<0.05 or <0.01. Com‐pared with non - event group , there was significant rise in serum BNP level [(684.28 ± 192.76 ) ng/L vs . (992.63 ± 327.58) ng/L] ,and significant reductions in serum levels of T [(5.68 ± 1.04)μg/L vs .(3.35 ± 0.97)μg/L] and FT3 [(4.41 ± 0.78) pmol/L vs .(2.31 ± 0.62) pmol/L] in event group ,P<0.01 all .Linear correlation analysis indicated that cardiac function class was positively correlated with serum BNP level (r=0.314 ,P=0.023) ,and inversely correlated with serum T and FT3 levels(r= -0.272 ,-0.167 ,P=0.028 ,0.034) .Conclusion:Serum BNP ,T and FT3 levels are closely related with heart function in male CHF patients ,may provide important reference bases for diagnosis and evaluating prognosis .