Pure perforator free sensory proximal ulnar artery perforator flap for resurfacing hand defects.

OBJECTIVE: This prospective study was performed to investigate the distribution of proximal ulnar artery perforating vessels through three-dimensional blood vessel reconstruction and examine the presence and consistency of the perforating vessels intraoperatively. METHODS: For anatomical guidance, three-dimensional blood vessel reconstruction was performed to determine the consistent presence of perforating vessels in the proximal ulnar artery. A free proximal ulnar artery perforator flap was then transferred in 17 patients to resurface skin defects on the hands. Color Doppler ultrasound was used to identify and mark the perforating vessels. Intraoperative evaluation was conducted to check for anastomosis of the perforating vessels at the marked sites and assess the vessel anastomosis conditions. RESULTS: No vascular crisis, flap necrosis, or wound infection occurred after surgery in 15 patients. Postoperative follow-up was conducted for 6 to 36 months. The appearance of the flap was satisfactory, the texture of the flap was soft, sensation was well restored, and hand function was not limited. The mean two-point discrimination of the flap was 7.6 ± 2.2 mm. CONCLUSIONS: Free sensory proximal ulnar artery perforator flap transfer is a safe and reliable surgical technique with respect to restoration of both the appearance and sensory function of the hand.

[Relationship between radiographic parameters and clinical outcomes of elderly patients with distal radius fractures].

OBJECTIVE: To analyze the relationship between radiographic parameters and clinical outcomes of patients with distal radius fractures in elderly patients following conservative treatment, and find the important radiographic parameters with distal radius fractures in elderly patients. METHODS: From May 2012 to May 2015, a retrospective analysis was performed of 45 elderly patients with distal radius fractures treated by conservative treatment, which including 17 males and 28 females with an average age of 64.49 years old from 60 to 89 years old. The imaging parameters were measured and the clinical efficacy was evaluated. The imaging parameters on the standard wrist joint X-ray picture were measured including metacarpal angle, the radius height, the ulna variation, the ulnar angle, and so on. The clinical effect of wrist joint was evaluated by Dienst score standard. Multiple factor linear regression was used to analyze the relationship between the image parameters and the clinical efficacy. RESULTS: All patients were followed up for 12 to 24 months with an average of 17.6 months. All fractures of the distal radius were healed. According to the Dienst evaluation, at the final follow-up the result was excellent in 27 cases, good in 10 cases, fair in 6 cases and poor in 2 cases. There was a significant correlation between the height of the radius, the angle of the palmar and the variation of the ulna and the function of the wrist joint in the imaging parameters. When the radius height more than 8.12 mm, the palmar angle more than -1.64 degree and the ulna variant less than 4.05 mm, the result of Dienst function was better. CONCLUSIONS: The imaging parameters such as the radius height, the palmar angle and the ulna variation are related to the recovery of the clinical efficacy of the distal radius fractures in the elderly. The most important parameter is the radius height, which reminds the surgeon to pay special attention to the reduction of the radius fracture in the elderly.

[Anatomical study and clinical application of the sensory perforator flap from the ulnar palmar digtal artery of the little finger].

Objective: To study the anatomical basis of the sensory perforator flap from the ulnar palmar digtal artery of the little finger and its application in reconstruction of soft tissue defect on the finger pulp. Methods: The origins and distributions of the blood vessels and nerves of the hypothenar region were observed in 6 fresh cadavers whose upper limbs were perfused with red latex. From September 2013 to November 2015,13 cases with soft tissue defects on the finger pulp were treated. All patients received the sensory perforator flap from the ulnar palmar digtal artery of the little finger. The donor site was sutured directly. Results: Through anatomical study, we found that the ulnar palmar digital artery of the little finger gives off constant cutaneous perforarter to nourish the skin of the hypothenar region, so do the ulnar palmar digital nerve of the little finger. The diameter of the artey is about 1.28 mm and suitable for microvascular anastomosis. All the 13 flaps survived. The patients were followed up for 3 months to 15 months. All the flaps had a good appearance. The sensation of the flaps recovered to S3 and two-point discrimination was 8-9 mmm. All the fingers had good function. There was only one linear scar on the hypothenar region without any discomfort. Conclusions: The ulnar palm digital artery of the little finger contains constant branches to nourish the skin of the hypothenar region, so do the ulnar palrnar digital nerve of the little finger. So we can design a flap with sensory nerve on the hypothenar region. It is an effective method to repair soft tissue defect of the finger pulp with the free sensory perforator flap from the ulnar palmar digtal artery of the little finger.

Flexible ferroelectric polymer devices based on inkjet-printed electrodes from nanosilver ink.

High-quality silver (Ag) patterns were inkjet-printed with nanosilver ink on a flexible polyethylene terephthalate (PET) substrate. All-solution-processed flexible ferroelectric polymer devices that use inkjet-printed Ag to create their bottom and top electrodes were demonstrated. The active layer, a poly (vinylidene fluoride-trifluoroethylene) (PVDF-TrFE) thin film, was spin-coated from solution. The devices have a remanent polarization of 8.03 µC cm(-2) and a coercive field of 68.5 MV m(-1), which is comparable to the device with evaporated-Ti electrodes on a silicon substrate. Based on the results presented in this paper, mass production of flexible ferroelectric devices is predictable.