Fibular head composite flap for bone and skin defect at medial malleolus in children: a report of 4 cases / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of fibular head composite flap for bone and skin defect at medial malleolus in children.</p><p><b>METHODS</b>From Aug. 2005 to Apr. 2009, 4 children cases (2 male, 2 female, from 3 to 11 year) with bone and skin defect at medial malleolus were reconstructed with fibular head composite flaps pedicled with lateral inferior genicular vascular bundle. The skin defect was 3- 6 cm x 8-10 cm in size.</p><p><b>RESULTS</b>All the 4 composite flaps survived completely. The patients were followed up for 4 months to 4 years with good bony healing. Both esthetic and functional results were satisfactory in ankle joint.</p><p><b>CONCLUSIONS</b>The fibular head composite tissue flap has a good therapeutic effect for bone and skin defect at medial malleolus in children.</p>

Chinese herbs application combined with operation for treating post-traumatic tibial osteomyelitis complicated with bone-skin defects / 中国骨伤

<p><b>OBJECTIVE</b>The aim of this study was to explore the method and clinical effects of integration of Chinese herbs and operation for the treatment of post-traumatic tibial osteomyelitis complication with bone-skin defect.</p><p><b>METHODS</b>Among 28 patients with post-traumatic tibial osteomyelitis complicated with bone-skin defects, 18 patients were male and 10 females, ranging in age from 18 to 68 years, with an average of 32.5 years. All the patients were treated with transplantation of free iliac flaps to one-stage repair the bone-skin defects after infection controlled with Chinese herbs dressing. The curative effects were analyzed.</p><p><b>RESULTS</b>All the patients were followed up and ranged from 8 to 56 months, with an average of 30 months. All of the flap survived, and the wounds got primary healing in 26 patients and secondary healing in 2 patients. All the grafted bone united in 2 to 14 months,with a mean time of 4.6 months. The osteomyelitis recurred in 2 patients and got healed by focal debridement.</p><p><b>CONCLUSION</b>Chinese herbs application combined with operation for treating post-traumatic tibial osteomyelitis complicated with hone-skin defects is effective to control infection, one-stage repair the tissue defects, which is worthy popularizing.</p>

Repairing soft-tissue defection of ankle and foot by sural neurovascular pedicle fasciocutaneous reversed island flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the clinical application of sural neurovascular pedicle fasciocutaneous reversed island flap to repair soft-tissue defection of the ankle and foot.</p><p><b>METHODS</b>From Sep. 1994 to Oct. 2004,29 patients with soft-tissue defects in the ankle and foot were repaired by use of sural neurovascular fasciocutaneous reversed island flap, including 15 cases of traumatic defects, 11 cases of burns and 3 cases of chronic ulcer. The flap area ranged from 5 cm x 7 cm to 12 cm x 20 cm, and the length of pedicle from 5 cm to 12 cm.</p><p><b>RESULTS</b>The flaps survived totally in 27 cases, the distal necrosed partially and secondary free-skin grafting were further conducted in 2 cases. Twenty-one cases were followed-up for 3 to 60 months,the circulation, color and texture of the flaps were excellent and 2-point discrimination was 10 - 15 mm. The appearance and function of ankle joints were good.</p><p><b>CONCLUSION</b>This flap has sufficient blood supply and a high survival rate; It is convenient in design, dissection and without sacrifice of major arteries. So, it is an effective method for the reconstruction of soft-tissue defects in ankle and foot.</p>

Finger reconstruction with extended free second toe flap transfer / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate an ideal method for finger reconstruction with extended the second toe flap transfer.</p><p><b>METHODS</b>The second toe free flap was created, combined with an pedicled skin flap from the fibular side of the great toe inlaid in the ventral side of the second toe, a double-wing flap and the distal part of the metatarsal bone. The composite free flap was transferred by vascular anastomosis for finger reconstruction.</p><p><b>RESULTS</b>The reconstructed finger exhibited nice looking and better function. The procedure had little influence to the appearance and function of the donor foot.</p><p><b>CONCLUSION</b>This method is effective in ameliorating the appearance and function of the reconstructed finger with the second toe transfer.</p>