Correction of Severely Asymmetric Calf using Latissimus Dorsi Musculocutaneous Free Flap and Customized Silicone Implant

Calves can be easily seen in daily life and are an important part of the body contour. Asymmetric calves can develop from unbalanced distribution and deposition of fat and muscles between the legs. Calf asymmetry may be due to congenital factors, disease (e.g., poliomyelitis, cerebral palsy, or infection), spinal cord injury, or the effects of surgical treatment and may have severe adverse psychological and social implications. Generally, an asymmetric calf is diagnosed when the difference of the longest circumference between both calves is more than 2 cm. Several surgical methods have been introduced for the correction of an asymmetric calf. Implant insertion or fat injection is used to augment a hypotrophic calf. Selective neurectomy, liposuction, muscle resection, radiofrequency, and botulinum toxin injection are used to treat a hypertrophic calf. With the development of microsurgery, the authors planned to use a latissimus dorsi musculocutaneous free flap (LDMC free flap) with silicone implant to add calf volume to obtain natural calf contour. The authors present the first successful case of correction of a severely asymmetric calf using an LDMC free flap and customized silicone implant.

PROSTHETIC DISC NUCLEUS REPLACEMENT FOR TREATMENT OF DEGENERATIVE LUMBAR DISC DISEASES / 解放军医学杂志

Objective To eveluate the result of the use of prosthetic disc nucleus (PDN) for treatment of degenerative disc diseases in the lumbar spine. Methods Twenty-two patients with degenerative disc diseases were treated with PDN replacement after the removal of the degenerated intervertebral disc. Results The patients were followed-up for an average 12 months (4-18 months). Both lumbago and leg pain disappeared in all the 22 patients who resumed their work and normal life one month after the operation. PDN translocation was found in 2 out of 10 patients in the early period, but no PDN translocation was found in the remaining 12 patients in the later period. Conclusion PDN could restore disc height and flexibility after nucleotomy. Artificial nucleus replacement was a good option for the treatment of degenerative lumbar disc disease.