ABSTRACT
A calcaneal desmoplastic fibroma in a 24-year-old woman had previously been treated with repeated curettage and bone grafting. Because of a larger recurrence a microvascular bone reconstruction was carried out using an osteofascial radial forearm flap. She could walk without pain in one year. It has not recurred during a five-year follow-up period.
Subject(s)
Bone Neoplasms/surgery , Bone Transplantation , Calcaneus , Fibroma, Desmoplastic/surgery , Neoplasm Recurrence, Local/surgery , Adult , Curettage , Female , HumansABSTRACT
Thirty-nine patients with Kienböck's disease underwent silicone replacement arthroplasty between 1979 and 1994. The patients were followed-up from 1 to 18 years (mean, 8 years). Sixteen prostheses (41%) have had to be removed, from 1 to 18 years postoperatively (mean, 5.6 years), 15 of them because of pain and silicone synovitis or cysts. It appears that silicone synovitis with cyst formation is an inevitable problem in the wrist after silicone replacement arthroplasty of the lunate, and this procedure is only a temporary solution for Kienböck's disease.
Subject(s)
Arthroplasty, Replacement/methods , Carpal Bones/surgery , Osteochondritis/surgery , Silicone Elastomers/therapeutic use , Adolescent , Adult , Aged , Arthroplasty, Replacement/statistics & numerical data , Carpal Bones/diagnostic imaging , Chi-Square Distribution , Female , Follow-Up Studies , Humans , Male , Middle Aged , Osteochondritis/diagnostic imaging , Radiography , Risk Factors , Survival AnalysisABSTRACT
Fifty free flap operations in 49 patients were performed in Oulu University Central Hospital during a three year period. The patients' ages ranged from 15 to 83 years; mean 41 years. The indication for the operation was malignant tumor in 19 cases, benign tumor in one case, trauma in 28 cases and congenital anomaly in 2 cases. The radial forearm flap was used in 36 cases; latissimus dorsi in 7 cases; lateral arm, rectus abdominis, and fibula in two cases; and second toe in one case. Forty-nine of the fifty flaps were successful (98%); two venous thromboses were successfully revised. Starting microsurgery in a new unit is demanding but also rewarding due to the good results.
Subject(s)
Surgical Flaps/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Bone Transplantation/methods , Cause of Death , Female , Finland/epidemiology , Forearm/surgery , Graft Survival , Head and Neck Neoplasms/surgery , Humans , Male , Microsurgery/statistics & numerical data , Middle Aged , Muscles/transplantation , Radius , Surgery Department, Hospital/statistics & numerical data , Survival Rate , Wounds and Injuries/surgeryABSTRACT
Perivascular sympathectomy, which has been used for vasospastic disorders of the hands, was examined in experimental models. Perivascular sympathectomy was performed on the central ear vessels and forepaw metacarpal vessels of the rabbit and on the common digital vessels in the monkey. The effects on adrenergic nerves were studied using a glyoxylic acid-induced fluorescence method. Adrenergic nerves were removed only at the site of the perivascular sympathectomy and the distal adrenergic innervation appeared normal. Because the distal sympathetic nerves appeared normal after the operation, it should rather be called adventitectomy and we feel its clinical effects should be reevaluated.
Subject(s)
Blood Vessels/innervation , Sympathectomy , Sympathetic Nervous System/physiology , Animals , Female , Macaca , Male , RabbitsABSTRACT
Two patients presented with loss of skin in the Achilles tendon region, which is difficult to repair satisfactorily. They were both treated with microvascular flaps, one of which was taken from the lateral arm, and the other from the radial forearm. Both methods gave good functional results.
