Microsurgical treatment of infected extremities after blood vessel prosthesis / 中华显微外科杂志

@#Objective To report the clinical effects of microsurgery in treatment of infected extremities after blood vessel prosthesis were transplanted.Methods From Jan.1998 to Dec.2008,8 cases of major vascular injuries in extremities were blood-supplied by cross bridge vascular anastomosis from uninjured extremities,including 4 cases of femoral artery and vein,2 cases of popliteal artery and vein,and 2 cases of brachial artery and vein. Results After 3 years of follow-up,blood circulation of infected extremities were reestablished in each of 8 cases,as well as function and appearance recovered.Conclusion The procedure of cross bridge vascular anastomosis from uninjured extremities may efficiently restitute the blood supply of the infected extremities after blood vessel prosthesis were transplanted,and decrease the rate of amputation.

Bone and skin defects of forefoot repaired by ailograft and complex flap with periosteum / 中华显微外科杂志

ObjectiveTo report the clinic result of bone and skin defects of forefoot and defects of forefoot treated by allograft and complex flap of crural artery with nerve and periosteum. Methods Allograft and complex flap with periosteum of tibien were used to repair bone and skin defects of forefoot in 9 cases ,in which the defects of forefeet were reconstructed by sequential connection with the complex flaps of tibialis posterior artery with saphenous nerve and periosteum in 2 cases. Results Six cases were survived completely;distal part in surface layer of flaps were necrosis partly in 3 cases and healed by dressing. After operation ,the repaired bone and joint showed normal position and recovered arcus pedis transversalis and arcus pedis longitudinalis by X-ray films. The patients were followedup from 3 months to 3 years,all grafted allograft had showed bone union and hadnt showed complications such as absorption,infection and repulsion. The injuried foot was restored its weight-bearing and walking functions and obtained a satisfactory contour. After operation,sensory recovery of foot occurred about 2 months. ConclusionUsed allograft is easy to do and recover arcus plantaris. The reverse complex flaps of tibialis anterior artery with periosteum have advantages as follow :the advoidance of influencing blood supply of injuried foot ,advancing symphysis ,short treatment course,simply procedure ,walking functions recovered ,good appearance and sensation.

Clinical application of dorsal carpometacarpal reversed island flap with dorsal metacarpal nerve to reconstruct finger / 中华显微外科杂志

Objective To investigate the clinical effect of dorsal carpometacarpal reversed island flap with dorsal metacarpal nerve to reconstruct finger. Methods We designed the dorsal reverse carpal and metacarpal island flaps with nerve by using the adjacent two dorsal matacarpal arteries as blood-supply and applied the stand of bone and tendon in waste finger or the free iliac transplantation to reconstruct the every sensory finger. Results Eighten cases were survived completely, and the skin degloving injuries of the finger in 3 cases. The maximum of the flap was 9cm by 8cm. Patients were followed up 3 months to 2 years,7 weeks later pain sense of reconstructed finger was recovered. Sensation over S3 amounts to 89% of the digits. Two-point-discrimination of the digits was 5-10mm. After the operation, the reconstructed finger obtained good appearance, the sensory recovery approach normally. The patients have ability to fulfil daily activities. Conclusion This method has advantages as follow:simple and practical,high survive rate,low impairment,sensible and good appearance.