Clinical efficacy of digital arteria axial flap augment volume in treatment of Wassel type III-V congenital thumb duplication: A report of 14 cases / 吉林大学学报(医学版)

Objective: To explore the clinical efficacy of digital arteria axial flap augment volume in the treatment of Wassel type III- V congenti tal thumb duplication, and to provide the basis for its clinical treatment. Methods: The thumb augment volume surgery was performed in 14 children with Wassel type III-V congenital thumb dupliation. A narrow and long flap with vascular vessel and soft tissue was designed with microsurgical technique to augment the soft tissue of the reconstructed thumb and reconstruct the perimeter and appearances of the reconstructed thumb. The perimeters and appearences of the reconstructed thumb and healthy thumb were detected before and after surgery. Results: All the flaps were survived after the surgery. The average perimeter of the reconstructed thumb was 89% -104% relative to the healthy contralateral thumb based on the data detected from the tuberositas unguicularis, proximal interphalangeal joint, proximal phalanx midshaft, metacarpophalangeal joint and metacarpal midshaft. The appearance of reconstructed thumb was more similar to that of healthy thumb. Conclusion: The digital arteria axial vascular flaps which are used to augment the volume of reconstructed thumb of Wassel type IH - V congenital thumb duplication can be easily obtained and the reconstructed thumbs have better appearences. The surgery is an effective way to improve the thin and small appearences of reconstructed thumbs.

The vascular supply of hip joint and its clinical significant / Suministro vascular de la articulación de la cadera y su significado clínico

The hip joint gains its vascular supply from the superior gluteal arteries as well as from the medial and lateral circumflex femoral arteries with the first perforating artery. In gluteal trauma, the superior and inferior gluteal artery may be affected which may end with vascular insult of hip joint. The current study includes a dissection of 171 cadavers to examine the vascular supply of hip joint. In 99.3% of articular branch arises from the superior gluteal artery either directly or indirectly (95.4% or in 3.9%, respectively). In 81% of articular branch arises from the inferior gluteal artery either directly or indirectly in 78% or in 3%. In 20.3% of articular branch arises from the coexistence of sciatic artery either directly or indirectly (17.7% or in 2.6%, respectively). Infrequently, the internal pudendal artery gives articular branch in 0.4%. Further, there is no difference between male and female in hip joint supply in current study. Based on current study's result, the dominant articular branch of vascular supply of the hip joint comes from the superior gluteal artery whereas the inferior gluteal artery comes beyond due its congenital absence. The coexistence sciatic artery is a replacement artery for superior or inferior gluteal artery in case of congenital absence. Due to aneurysm of the three previous arteries after trauma, it is important to study their course and articular branches to avoid iatrogenic fault of joint vascular insult during surgical management of either true or false aneurysm.

La articulación de la cadera obtiene su suministro vascular desde las arterias glúteas superiores, así como desde las arterias circunflejas femorales lateral y medial y la primera arteria perforante. En el trauma glúteo, las arteria glúteas superior e inferior pueden verse afectadas, lo que puede terminar con una lesión vascular de la articulación de la cadera. Este estudio incluyó la disección de 171 cadáveres con el fin de examinar el suministro vascular de la articulación de la cadera. El 99,3% de las ramas articulares se originan de la arteria glútea superior, ya sea directa o indirectamente (95,4% o en 3,9%, respectivamente). En 81% de los casos, la rama articular sse origina de la arteria glútea inferior, directa o indirectamente (78% y 3%, respectivamente). El 20,3% de la rama articular se origina de la conexistencia de la arteria ciática, ya sea directa o indirectamente (17,7% y 2,6%, respectivamente), y con poca frecuencia, la arteria pudenda interna origina una rama articular (0,4%). Además, los resultados no mostraron diferencia en el suministro de articulación de la cadera entre hombres y mujeres. En base a nuestros resultados, podemos señalar que la rama articular dominante de suministro vascular de la articulación de la cadera proviene de la arteria glútea superior, mientras que la arteria glútea inferior aporta de manera escasa debido a su ausencia congénita. La coexistencia de una arteria ciática, constituye un reemplazo de las arterias glútea superior o inferior en caso de ausencia congénita. En caso de un aneurisma de alguna de las tres arterias anteriores, posterior a un trauma, resulta importante estudiar su curso y ramas articulares para evitar una lesión vascular iatrogénica conjunta durante el tratamiento quirúrgico de aneurisma de tipo verdadero o falso.

Morphometrics of Arterial Supply for Superficial Circumflex Iliac Artery Flap in Koreans / 체질인류학회지

We studied the distribution patterns of perforating branch of superficial circumflex iliac artery for flap surgery in Korean. Fifty one thighs from 34 Korean cadavers (17 males/ 17 females) were dissected and standard points were determined as follows: point of anterior superior iliac spine (A), point of pubic tubercle (B), cross point of the line AB and femoral artery (FA), cross point of the femoral artery and the sartorius muscle (FAS), beginning point of superficial circumflex iliac artery (O), and perforating point of superficial circumflex iliac artery (P). We measured the distance and the angles between the standard points. Each frequency of superficial circumflex iliac artery from femoral artery and superficial epigastric artery is 69.6% and 30.4% respectively. The mean distance between the beginning point of superficial circumflex iliac artery (O) and the point A was 7.3+/-1.3 cm and the mean distance between the point O and the point B was 5.7+/-0.6 cm. The angle from line OA to line AB was 17.9+/-8.0 degrees and The angle from line OB to the line AB was 24.9+/-5.1 degrees. The mean distance between the perforating point for superficial circumflex iliac artery (P) and the point A was 6.3+/-2.4 cm and the mean distance between the point P and the point B was 8.3+/-2.7 cm. The angle from line PA to line AB was 33.4+/-18.3 degrees and the angle from line PB to the line AB was 24.5+/-14.3 degrees. Consequently, the pattern of distribution of superficial circumflex iliac arteries, obtained in this study, will provide useful anatomical backgrounds for the superficial circumflex iliac artery flap surgery in Korean.

Morphometrics of Arterial Supply for External Pudendal Artery Flap in Koreans / 체질인류학회지

This study was performed to measure the distance of perforating point for superficial and deep external pudendal arteries from pubic tubercle and anterior superior iliac spine, patterns of arterial distribution, and external diameter. Fifty three thighs from 27 Korean cadavers (13 males / 14 females), clinically normal and without deformity, were dissected and standard points were determined as follows: point of pubic tubercle (A) and point of anterior superior iliac spine (B). The obtained results were as follows: 1. The external pudendal artery branched from femoral artery was distributed in the medial thigh. Superficial external pudendal artery is located above the saphenous opening and Deep external pudendal artery is located below the saphenous opening. 2. The saphenous opening were 4.7+/-1.2 cm apart from point A and 10.1+/-1.3 cm from B. 3. The superficial external pudendal artery were 5.2+/-1.2 cm apart from A and 8.9+/-2.1 cm from B. 4. The deep external pudendal artery were 4.7+/-1.1 cm apart from A and 10.8+/-1.3 cm from B. Consequently, the patterns of distribution of superficial and deep external pudendal arteries, obtained in this study, will provide useful anatomical backgrounds for the external pudendal flap surgery in korean.

Persistence of the axial artery of the lower extremity in Thais.

The lower extremities of 233 (119 male and 114 female) Thai cadavers were studied during the periods 1966-1967 and 1987-1988 in the Department of Anatomy, Faculty of Medicine Siriraj Hospital. The age of the cadaver ranged from 16-98 years. The pattern of the arterial supply of 440 lower extremities of the cadavers was recorded, with right-side supply being 224 and left-side 216. Various types of persistence of the axial artery were found in 13 of the 440 lower extremities (3%). In one left lower-extremity, the axial artery remained as the main artery arising from the internal iliac artery, passing through the infrapiriform foramen and descending with the sciatic nerve to be a popliteal artery. In eight lower extremities, the distal segment of the middle part of the axial artery in the popliteal fossa persisted as the lower part of the popliteal artery (in teo of the lower extremities), and the root of the anterior tibial artery (in six of the lower extremities). In four lower extremities, the axial artery remained as the peroneal artery which is a direct continustion of the politeal srtery. The posterior tibial artery was absent in these cases.