ABSTRACT
Objective To discuss a design of flap of dorsal branches of the digital proper artery to repair pediatric middle phalanx skin defects and its effect.Methods From October,2013 to March,2015,antegrade flaps were used to treat 9 pediatric patients with skin defect in middle phalanx,the dorsal branches of the digital proper artery were used as the pedicel.The dorsal branch of digital proper nerve carried by flap was sutured with digital proper nerve in wound surface of middle phalanx,flap cutting area was 3.5 cm × 1.2 cm-2.5 cm × 0.8 cm,the donor site of flap was repaired by full thickness skin graft.Results All the 9 flaps survived,and primary healing in the wound of donor and recipient site.The 9 patients were followed up for 6-12 months,with an average of 8 months.All the flaps had soft texture and full shape,the two-point discrimination was 5-9 mm,6.5 mm on average.Conclusion To repair skin defect in the middle phalanx with flap using the dorsal branches of the digital proper artery as the pedicel and sutured the dorsal branch of digital proper nerve,combine advantages of the simplicity,high skin flap survival rate,good postoperative appearance and sensation recovery.
ABSTRACT
@#Objective To study the mechanism, pathology, diagnosis and manage strategy of cervical fracture dislocation combined with anterior spinal cord syndrome (ASCS). Methods 32 cases of cervical fracture dislocation combined with ASCS from January 2012 to September 2014 were summarized. The mechanisms of injury and pathological characteristics were analyzed. All of them received surgical treatment. Anterior approach or anterior approach combined with posterior approach was chosen according to the characteristics of injury. Results All surgical treatments were successfully performed. There were 22 cases (68.75%) with hyperflexion, 5 cases (15.62%) with vertical hit, 1 case (3.12%) with hyperextension and 4 cases (12.5%) with multiple reasons. There were 4 cases (12.5%) with simple anterior dislocation, 28 cases (87.5%) with fracture combined with anterior dislocation. Only 8 cases were successfully diagnosed as ASCS, and the others (24 cases) were generally defined as spinal cord injury. Conclusion ASCS is not so rare. Hyperflexion injury is the most common mechanism. Anterior dislocation and fracture combined with anterior dislocation are the general types of pathology. Conscientious physical examination with CT and MRI can facilitate the diagnosis. Anterior approach or combined with posterior approach could be selected according to injury mechanism.
ABSTRACT
Objective To study the mechanism, pathology, diagnosis and manage strategy of cervical fracture dislocation combined with anterior spinal cord syndrome (ASCS). Methods 32 cases of cervical fracture dislocation combined with ASCS from January 2012 to Sep-tember 2014 were summarized. The mechanisms of injury and pathological characteristics were analyzed. All of them received surgical treat-ment. Anterior approach or anterior approach combined with posterior approach was chosen according to the characteristics of injury. Re-sults All surgical treatments were successfully performed. There were 22 cases (68.75%) with hyperflexion, 5 cases (15.62%) with vertical hit, 1 case (3.12%) with hyperextension and 4 cases (12.5%) with multiple reasons. There were 4 cases (12.5%) with simple anterior disloca-tion, 28 cases (87.5%) with fracture combined with anterior dislocation. Only 8 cases were successfully diagnosed as ASCS, and the others (24 cases) were generally defined as spinal cord injury. Conclusion ASCS is not so rare. Hyperflexion injury is the most common mecha-nism. Anterior dislocation and fracture combined with anterior dislocation are the general types of pathology. Conscientious physical exami-nation with CT and MRI can facilitate the diagnosis. Anterior approach or combined with posterior approach could be selected according to injury mechanism.