ABSTRACT
Objective To explore the efficacy of peroneus brevis tendon transfer and peroneal tendofascial flap for repairing achilles tendon and overlying skin defect.Methods From April,2004 to May,2015,5 cases of achilles tendon and overlying skin defect were treated with peroneus brevis tendon transfer and peroneal tendofascial flap.In these cases,the length of the achilles tendon defect was from 3.0 cm to 8.0 cm,and the size of skin defect ranged from 2.0 cm × 3.0 cm to 3.0 cm × 5.0 cm.Using peroneus brevis tendon to reconstruct achilles tendon defect,and covered with peroneal tendofascial flap,and then skin graft.One of them combined with the gastrocnemius tendon V-Y advancement to promote the reconstruction of achilles tendon longer defect.The patients were followed-up regularly,and evaluated by the American Society of Ankle Arrhythmia (AOFAS) ankle-hindfoot scoring system.ResultsAll operations were successful and the grafted skin survived.All cases were followed-up from 6 months to 10 years with an average of 5.2 years.At the time of last followed-up,all wounds healed well without re-infection and ulceration.Not foot varus deformity and the strongth was back to the level before the injury.AOFAS ankle-hindfoot score was increased from (50.44 ± 12.05)(preoperative) to (90.02 ± 6.55)(the last follow-up) (P＜0.05).Conclusion There were some advantages in the method of the treatment of achilles tendon and overlying skin defect by using peroneus brevis tendon transfer and peroneal tendofascial flap,such as easy to cut,small damage to the donor area,and no significant deformity to the receptor area,etc.It is a good way to repair achilles tendon and overlying skin defects.
ABSTRACT
Objective To summarize the clinical experience in the replacement of the damaged sec- ond metacarpophalangeal joint with the second metatarsophalangeal joint with a pedicle of dorsal pedis artery and great saphcnous vein.Methods The damaged second metacarpophalangeal joint,distal part of the sec- ond metacarpal and proximal part of the proximal phalanx were dissected.The metatarsophalangeal joint was transferred to the region of metacarpophalangeal joint of hand.The dorsal pedis artery was anastomosed to the radial artery,and the great saphenous vein was anastomosed to the cephalic vein at anatomical snuff-box.The dissected bones of the hand removed of the cartilage of joint and soft tissue were grafted back to the donor site of the foot.Results A 5～30 month follow-up study in 8 out of 11 cases showed that satisfactory functional recovery was achieved in clinical practice.The movement of second metacarpophalangeal joint was excellent. Conclusion The function of the second metacarpophalangeal joint can be effectively recovered by the trans- fer of the vascularized second metatarsophalangeal joint.