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Objective To observe the clinical outcomes of the superior gluteal neurocutaneous flap for sacrococcygeal pressure sores. Methods Twelve cases with sacrococcygeal pressure sores were covered by the superior gluteal neurocutaneous flap from May 2005 to Nov. 2009. The sore size ranged from 15 cm ×30 cm to 5 cm × 8 cm, while the flap size ranged from 17 cm × 32 cm to 10 cm× 12 cm. Results All 12 flaps survived totally with the pressure sores healed. The longest follow-up time was four years, the short follow-up time was half a year, the average time was 2.5 years. The superior gluteal neurocutaneous flap was good blood circulation, pressure sores not recur. Conclusion The superior gluteal neurocutaneous flap is a good treatment for sacrococcygeal pressure sores for its reliable blood supply and simple harvesting.
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Objective To discuss experiences in reconstruction of severe tibial shaft fractures by using different flaps and external fixations.Methods The study involved 190 patients with type GustiloⅢB Ⅲ C (160 patients) and GustiloⅢC (30 patients) tibial shaft fractures treated from 1990 to 2007.There were 169 males and 21 females,at average age of 42.5 years.The injury causes included traffic accidents in 132 patients,machine accidents in 32 and stone smashing in 26.The management procedure consisted of administration of antibiotics,serial debridement and different flap grafting (including free thoracoumbilical flaps in 20 patients,sural neurocutaneous vascular flaps in 108,saphenous neurocutane ous vascular flaps in 12,superficial peroneal neurocutaneous flap in two,fasciocutaneous flaps in 26 and gastrocnemius muscular flaps in 22) and different external fixators (half-ring fixators in 84 patients,unilateral axial dynamic fixators in 12,AO fixators in 10,Weifang fixators in 42 and hybrid fixators in 40).The average follow-up was 7.3 years.Results All flaps survived.Of all,186 patients obtained fracture healing,with mean fracture healing time varying in different patients treated with different external fixators:7.5 months for 84 patients treated with half-ring fixators,11.2 months for eight with unilateral axial dynamic fixators,8.5 months for 12 with AO fixators ,8.1 months for 42 with Weifang fixators and 7.8 months for 40 with assembly fixators.Except for half-ring fixation,the other fixators needed necessary bone graft.Four patients treated with unilateral axial dynamic fixators resulted in nonunion due to osteo myelitis.The latest follow up showed that the function of the ankle and knee was normal,with no pain.Conclusion Combination of half-ring external fixators with various flaps provides good method for treatment of Gustilo ⅢB and ⅢC tibial shaft fractures.
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[Objective]To evaluate the biomechanical features of Ni-Ti shape memory alloy stemless femoral prosthesis.[Method]Using CT(computer tomography) scanning photographs of adult femur,three-dimensional model of the femur was built by CAD(computer aided design) software.Based on the the structure of femoral model,shape memory alloy stemless femoral prosthesis was designed.Three-dimensional finite element model was created for the normal femur,Ni-Ti shape memory alloy stemless femoral prosthesis,and traditional stemmed hip prosthesis.Under static loads and walking loads,the Von Mises stress distributions of each model were analyzed and compared.[Result]The stress distribution of shape memory alloy stemless femoral prosthesis was not obviously different from normal femur,stemless femoral prosthesis's proximal femoral stress was close to that of normal femoral model but significantly higher than traditional stemmed hip prosthesis.Von Mises stress of memory alloy claws was distributed evenly,and the Max was only 13.23Mpa,there was no stress concentration.[Conclusion](1) Ni-Ti shape memory alloy stemless femoral prosthesis has great biomechanical properties,may reduce the stress-shieding effect of the proximal femur.The fixed method that use memory alloy claws can make prosthesis fixed firmly to the bone and reduce stress concentration.
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[Objective]To investigate the therapy of human enbryonic olfactory ensheathing cells(hOECs) transplantation on adult rats' transected spinal cord.[Method]Separated,cultured hOECS from abortus were obtained and percent age of P75 positive cells was calculated.Twenty-four Wistar rats were choosen and divided into experimental group and control group randomly.All rats of two goups were transected at the T_(10) segment of spinal cord.Nine to ten days later 5 ul(2.5?10~5) hOECs(labled by Hoechst 33342) were injected in the contusion area of lesion site in transplantation group.In control group same volume of DMEM-F12 were transplanted.1,2,4,6,8 and 10 weeks later all rats were estimated by system of the BBB locomotion score respectively.Then part of them were killed.The tissue section of spinal cords were separated and inspected by fluorescence microscope or the methods of immunohistochemical staining.Data were processed with statistical tools in double-blinded condition.[Result]Transplanted hOECs can survive for at least ten weeks and even migrated from the injuried area in spinal cord.From 4 weeks to 10 weeks the BBB locomotion scores of experimental group were improved significantly contrasting to that of control group(P
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Objective To observe the effects of early rehabilitation training on sensory restoration after the median nerve injuries. Methods Seventy patients with median nerve injuries were randomly divided into two groups: the rehabilitation group ( n =32), in which the patients received sensory reeducation two weeks after surgical treatment; and the control group ( n =38),in which the patients only received surgical treatment. After 6 8 weeks of treatment, reassessment were performed and the results were compared between the two groups. Results The excellent and effective rates of functional recovery in sensation in the rehabilitation group were 88% and 97%, respectively. A comparison showed that there was significant difference between the two groups. Conclusion Sensory reeducation could accelerate the restoration of sensation in patients with median nerve injury.
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Objective To study the security and effectiveness of leg lengthening in increasing the height of short stature for cosmetic reasons. Methods The improved bone lengthening technique was used to 60 adult short stature volunteers to prolong bilateral lower legs. All data, including healing time of the distracted bone, operative complications, recovery of limb function and height increment, were recorded. Results In all cases, the height increment was 5 to 10 cm (mean 6.8cm). Bone lengthening rate was 19.6 %. The healing time of the distracted bone was 6 to 16 months (mean 8.2 months). There was no severe complication occurred. Follow up for 2 to 8 years showed that all cases returned to work or study with normal gaits and satisfied body figure. Previous psychologic obstacles were eliminated. Two years after bone healing, the ability for intense activities was regained. Conclusion Leg lengthening for cosmetic heightening is a safe and effective therapeutic approach.
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Objective To study the effect of pulsing magnetic field (PMF) on the osteogenesis of the distracted region in cosmetic limb lengthening, and to search for an effective therapeutic method for promoting the recovery of the cosmetic patient. Methods Thirty adult short stature volunteers for cosmetic heightening were randomly divided into PMF group and control group, 15 in each group. Magnetic stimulation was given to the PMF group on the day after operation. X-ray examination was taken on fixed interval, and lengthening index was used for bone healing evaluation. Results The height increase ranged from 5～9 cm, mean (6.6?1.2) cm, and the mean lengthening rate was 19.2 % : 5～8 cm (6.2?1.1) cm in the PMF group and 5.2～9 cm (6.8?1.6)cm in the control group ( P
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Objective To study the biocompatibility of human hair keratin artificial tendon(HHKAT) material in vitro. Methods Human embryonic tendon cell (HETC) was incubated with various concentrations (100%,50%,10%) of extracted liquid of HHKAT material for 1,3,5 and 7 days, respectively. Collagen I expression in HETC was detected by immunocytochemistry. The effects of HHKAT material on the proliferation and ultrastructure of HETC were observed. Results Various concentrations of extracted liquid of HHKAT had no effect on the morphologic, collagen I expression and ultrastructure of HETC. HETC could adhere, grow and proliferate on the surface of HHKAT material. Conclusion HHKAT is a medical biomaterial with good biocompatibility in vitro.
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Objective To summarize the experience of microsurgical repair of soft tissue defects in 136 cases with firearm wound,to probe into repairing defect methods in different parts and to improve repairing results Methods According to the location,area of soft tissue defects or special needs,dorsalis pedis flap,latissimus dorsi flap,thoracoumbilical flap,forearm flap,lateral leg flap,tensor fascia lata flap or compound tissue flap were used to repair 136 cases with soft tissue defects in the firearm wound Results All 136 cases with soft tissue defects were repaired successfully Conclusions Microsurgical technique is a good method to repair soft tissue defects and reconstruct function in the firearm wound